Provider Demographics
NPI:1609987841
Name:AKRON NEPHROLOGY ASSOC INC
Entity Type:Organization
Organization Name:AKRON NEPHROLOGY ASSOC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:L
Authorized Official - Last Name:FRANK
Authorized Official - Suffix:
Authorized Official - Credentials:OM
Authorized Official - Phone:330-344-6072
Mailing Address - Street 1:224 W EXCHANGE ST
Mailing Address - Street 2:STE 330
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44302
Mailing Address - Country:US
Mailing Address - Phone:330-344-6072
Mailing Address - Fax:330-344-6447
Practice Address - Street 1:224 W EXCHANGE ST
Practice Address - Street 2:STE 330
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44302
Practice Address - Country:US
Practice Address - Phone:330-344-6072
Practice Address - Fax:330-344-6447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH012207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0636146Medicaid
OH0636146Medicaid