Provider Demographics
NPI:1326227471
Name:OHIO PAIN & REHABILITATION INC
Entity Type:Organization
Organization Name:OHIO PAIN & REHABILITATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:MS
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BABBO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-609-5533
Mailing Address - Street 1:8323 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-2342
Mailing Address - Country:US
Mailing Address - Phone:330-609-5533
Mailing Address - Fax:330-609-5553
Practice Address - Street 1:8323 E MARKET ST
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-2342
Practice Address - Country:US
Practice Address - Phone:330-609-5533
Practice Address - Fax:330-609-5553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-008609204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9321301Medicare PIN
OH2289296Medicaid