Provider Demographics
NPI:1003841396
Name:THE HEART GROUP, INC.
Entity Type:Organization
Organization Name:THE HEART GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-376-1500
Mailing Address - Street 1:3963 LOOMIS PKWY
Mailing Address - Street 2:
Mailing Address - City:RAVENNA
Mailing Address - State:OH
Mailing Address - Zip Code:44266-1800
Mailing Address - Country:US
Mailing Address - Phone:330-297-6110
Mailing Address - Fax:330-296-0592
Practice Address - Street 1:3963 LOOMIS PKWY
Practice Address - Street 2:
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266-1800
Practice Address - Country:US
Practice Address - Phone:330-297-6110
Practice Address - Fax:330-296-0592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0966905Medicaid
OH0966905Medicaid