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General NPI Number Information
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NPI Number | 1992334858
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Entity Type | Organization
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Legal Business Name | PACE HEALTHCARE LLC
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Dates
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Enumeration Date | 04/03/2020
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Last Update Date | 03/29/2023
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Provider Practice Location Address
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Address Line | 5225 CLEVELAND RD STE F
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City | WOOSTER
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State | OH
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Zip | 44691-5541
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Country | US
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Telephone | 330-625-4900
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Fax | 330-685-9355
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Provider Business Mailing Address
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Address Line | 13663 SEBE DR
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City | MARSHALLVILLE
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State | OH
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Zip | 44645-9767
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Country | US
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Telephone | 330-466-0724
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Fax | 425-969-2919
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Authorized Official
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Title or Position | OWNER
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Name | MR. KEITH WAYNE HOSTETLER
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Credential | RPH
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Telephone | 330-625-4900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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