Provider Demographics
NPI:1407455272
Name:FROMHART, JOSHUA (SERVICE COORDINATOR)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:FROMHART
Suffix:
Gender:M
Credentials:SERVICE COORDINATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:748 MCMECHEN ST
Mailing Address - Street 2:
Mailing Address - City:BENWOOD
Mailing Address - State:WV
Mailing Address - Zip Code:26031-1100
Mailing Address - Country:US
Mailing Address - Phone:304-233-3474
Mailing Address - Fax:304-233-2664
Practice Address - Street 1:748 MCMECHEN ST
Practice Address - Street 2:
Practice Address - City:BENWOOD
Practice Address - State:WV
Practice Address - Zip Code:26031-1100
Practice Address - Country:US
Practice Address - Phone:304-233-3474
Practice Address - Fax:304-233-2664
Is Sole Proprietor?:No
Enumeration Date:2020-10-22
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator