MEDICARE: PIONEER PHYSICIANS NETWORK INC.

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	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1244560008	OTHER	OH	DME SUPPLIER NUMBER

General Provider Information

NPI Number	:	1780619973
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PIONEER PHYSICIANS NETWORK INC.

Provider Business Mailing Address
First Line	:	3515 MASSILLON RD STE 300
Second Line	:
City	:	UNIONTOWN
State	:	OH
Zip	:	44685-7854
Country	:	US
Telephone Number	:	330-899-9350
Fax Number	:

Provider Business Practice Location Address
First Line	:	4880 S MAIN ST
Second Line	:	SUITE 4
City	:	AKRON
State	:	OH
Zip	:	44319-4474
Country	:	US
Telephone Number	:	330-644-2700
Fax Number	:	330-644-2797

Authorized Official
Title or Position	:	PRACTICE ADMINISTRATOR
Name	:	KATHLEEN M KOSTELNICK
Credential	:
Telephone Number	:	330-899-9350

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	08/14/2020

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