Provider Demographics
NPI:1659564904
Name:AURORA HEALTH & WELLNESS MEDICAL CENTER, INC
Entity Type:Organization
Organization Name:AURORA HEALTH & WELLNESS MEDICAL CENTER, INC
Other - Org Name:AURORA FAMILY CHIROPRACTIC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:J
Authorized Official - Last Name:BADALAMENTI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:330-562-3142
Mailing Address - Street 1:45 N CHILLICOTHE RD
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:OH
Mailing Address - Zip Code:44202-8702
Mailing Address - Country:US
Mailing Address - Phone:330-562-3142
Mailing Address - Fax:330-995-0230
Practice Address - Street 1:45 N CHILLICOTHE RD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:OH
Practice Address - Zip Code:44202-8702
Practice Address - Country:US
Practice Address - Phone:330-562-3142
Practice Address - Fax:330-995-0230
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AURORA HEALTH & WELLNESS MEDICAL CENTER, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-08-21
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH111N00000X
207LP2900X, 208VP0000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9343831Medicare PIN
OHU22687Medicare UPIN