Provider Demographics
NPI:1487821575
Name:AKRON ENT ASSOCIATES INC
Entity Type:Organization
Organization Name:AKRON ENT ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-762-8959
Mailing Address - Street 1:395 EAST MARKET STREET
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44304-1542
Mailing Address - Country:US
Mailing Address - Phone:330-762-8959
Mailing Address - Fax:330-762-9121
Practice Address - Street 1:395 E MARKET ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304-1542
Practice Address - Country:US
Practice Address - Phone:330-762-8959
Practice Address - Fax:330-762-9121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH02566332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0953339Medicaid
9222741Medicare PIN