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NPI Code Detail

MEDICARE: AULTMAN HEALTH FOUNDATION

MEDICARE: AULTMAN HEALTH FOUNDATION
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
1333600000XPharmacy
23336C0002XClinic Pharmacy021051600OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
23674428OTHERNCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number : 1689695652
Entity Type Code : Organization
Provider Name (Legal Business Name) : AULTMAN HEALTH FOUNDATION
Provider Business Mailing Address
First Line : 6100 WHIPPLE AVE NW
Second Line :
City : NORTH CANTON
State : OH
Zip : 44720-7618
Country : US
Telephone Number : 330-305-6999
Fax Number : 330-305-6997
Provider Business Practice Location Address
First Line : 6100 WHIPPLE AVE NW
Second Line :
City : NORTH CANTON
State : OH
Zip : 44720-7618
Country : US
Telephone Number : 330-305-6999
Fax Number : 330-305-6997
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : G SCOTT MCDONOUGH
Credential : MD
Telephone Number : 330-834-1111
Provider Enumeration Date : 07/22/2006
Last Update Date : 04/29/2010

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Directions to “AULTMAN HEALTH FOUNDATION ” Practice Location

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