Provider Demographics
NPI:1356509061
Name:PARAGON HEALTH ASSOCIATES LLC
Entity Type:Organization
Organization Name:PARAGON HEALTH ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL CREDENTIALING CONSULTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:MICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:234-855-6458
Mailing Address - Street 1:1 PARK WEST BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44320-4218
Mailing Address - Country:US
Mailing Address - Phone:330-869-9777
Mailing Address - Fax:330-869-0052
Practice Address - Street 1:468 E MARKET ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304-1594
Practice Address - Country:US
Practice Address - Phone:330-869-9777
Practice Address - Fax:330-869-0052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-29
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2856208Medicaid
OH9314771Medicare PIN