Provider Demographics
NPI: | 1295015634 |
---|---|
Name: | HEALTHY LIFE SCREENING |
Entity Type: | Organization |
Organization Name: | HEALTHY LIFE SCREENING |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT & CEO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | BARRY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | EASTERLING |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 330-670-0200 |
Mailing Address - Street 1: | 61 N. CLEVELAND-MASSILLON RD |
Mailing Address - Street 2: | SUITE E |
Mailing Address - City: | AKRON |
Mailing Address - State: | OH |
Mailing Address - Zip Code: | 44333-4557 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 330-670-0200 |
Mailing Address - Fax: | 330-670-0397 |
Practice Address - Street 1: | 61 N. CLEVELAND-MASSILLON RD |
Practice Address - Street 2: | SUITE E |
Practice Address - City: | AKRON |
Practice Address - State: | OH |
Practice Address - Zip Code: | 44333-4557 |
Practice Address - Country: | US |
Practice Address - Phone: | 330-670-0200 |
Practice Address - Fax: | 330-670-0397 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2011-08-17 |
Last Update Date: | 2011-08-17 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 247200000X | Technologists, Technicians & Other Technical Service Providers | Technician, Other | Group - Multi-Specialty |