Provider Demographics
NPI:1730640046
Name:OHIO NORTH EAST HEALTH SYSTEMS INC
Entity Type:Organization
Organization Name:OHIO NORTH EAST HEALTH SYSTEMS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:DWINNELLS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-747-9551
Mailing Address - Street 1:726 WICK AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44505-2827
Mailing Address - Country:US
Mailing Address - Phone:330-747-9551
Mailing Address - Fax:330-884-6120
Practice Address - Street 1:500 GYPSY LANE
Practice Address - Street 2:MEDICAL OFFICE BLDG A
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44504-1315
Practice Address - Country:US
Practice Address - Phone:877-722-3303
Practice Address - Fax:330-884-6120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-28
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
No124Q00000XDental ProvidersDental HygienistGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty