MEDICARE: AKRON GENERAL EXPRESSCARE CLINIC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1649425604
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AKRON GENERAL EXPRESSCARE CLINIC

Provider Business Mailing Address
First Line	:	1474 N MAIN ST
Second Line	:
City	:	NORTH CANTON
State	:	OH
Zip	:	44720-1640
Country	:	US
Telephone Number	:	330-497-7810
Fax Number	:

Provider Business Practice Location Address
First Line	:	1474 N MAIN ST
Second Line	:
City	:	NORTH CANTON
State	:	OH
Zip	:	44720-1640
Country	:	US
Telephone Number	:	330-497-7810
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF PHARMACY OPERATIONS
Name	:	MR. JOE LAHOVICH
Credential	:
Telephone Number	:	330-733-2263

Provider Enumeration Date	:	11/18/2008
Last Update Date	:	10/12/2009

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