Provider Demographics
NPI:1417162991
Name:INFO LINE, INC.
Entity Type:Organization
Organization Name:INFO LINE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:B
Authorized Official - Last Name:STAHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-762-5627
Mailing Address - Street 1:703 S. MAIN ST.
Mailing Address - Street 2:SUITE 211
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44311-1019
Mailing Address - Country:US
Mailing Address - Phone:330-762-5627
Mailing Address - Fax:330-253-1137
Practice Address - Street 1:703 S. MAIN ST.
Practice Address - Street 2:SUITE 211
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44311-1019
Practice Address - Country:US
Practice Address - Phone:330-762-5627
Practice Address - Fax:330-253-1137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0788554Medicaid