Provider Demographics
NPI:1760664957
Name:MCINTOSH COMMUNITY HEALTH CENTER INC
Entity Type:Organization
Organization Name:MCINTOSH COMMUNITY HEALTH CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:G,
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:MCINTOSH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-899-9533
Mailing Address - Street 1:3705 MASSILLON RD
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685-7770
Mailing Address - Country:US
Mailing Address - Phone:330-899-9533
Mailing Address - Fax:330-899-9544
Practice Address - Street 1:3705 MASSILLON RD
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:OH
Practice Address - Zip Code:44685-7770
Practice Address - Country:US
Practice Address - Phone:330-899-9533
Practice Address - Fax:330-899-9544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-29
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
9321161Medicare PIN