Provider Demographics
NPI:1083684658
Name:S & J MED., INC.
Entity Type:Organization
Organization Name:S & J MED., INC.
Other - Org Name:PARKMAN MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING CLERK
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KAMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-898-1723
Mailing Address - Street 1:2760 PARKMAN RD NW
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44485-1635
Mailing Address - Country:US
Mailing Address - Phone:330-898-1723
Mailing Address - Fax:330-898-7596
Practice Address - Street 1:2760 PARKMAN RD NW
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44485-1635
Practice Address - Country:US
Practice Address - Phone:330-898-1723
Practice Address - Fax:330-898-7596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-25
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2373140Medicaid
OH=========-00OtherBWC
OH2373140Medicaid
OH9297721Medicare PIN