Provider Demographics
NPI:1568870376
Name:FORCHIONE, ROSEANNE MARIE
Entity Type:Individual
Prefix:MS
First Name:ROSEANNE
Middle Name:MARIE
Last Name:FORCHIONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 NORTHRIDGE ST NW
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-4049
Mailing Address - Country:US
Mailing Address - Phone:330-704-0994
Mailing Address - Fax:330-244-0692
Practice Address - Street 1:315 NORTHRIDGE ST NW
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-4049
Practice Address - Country:US
Practice Address - Phone:330-704-0994
Practice Address - Fax:330-244-0692
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-24
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH765395343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)