Provider Demographics
NPI:1518046424
Name:HUBBARD SURGICAL FITTING CENTER
Entity Type:Organization
Organization Name:HUBBARD SURGICAL FITTING CENTER
Other - Org Name:HFSC
Other - Org Type:Other Name
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:VOULA
Authorized Official - Middle Name:
Authorized Official - Last Name:FOROSTY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:330-534-5678
Mailing Address - Street 1:10 EAST LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:HUBBARD
Mailing Address - State:OH
Mailing Address - Zip Code:44425-2159
Mailing Address - Country:US
Mailing Address - Phone:330-534-5678
Mailing Address - Fax:330-534-1975
Practice Address - Street 1:10 EAST LIBERTY ST
Practice Address - Street 2:
Practice Address - City:HUBBARD
Practice Address - State:OH
Practice Address - Zip Code:44425-2159
Practice Address - Country:US
Practice Address - Phone:330-534-5678
Practice Address - Fax:330-534-1975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN111673163W00000X
OH03211391183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
Not Answered183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
659178OtherSTATE LIC#