Provider Demographics
NPI:1851377949
Name:HEALTH CARE PROVIDERS INC
Entity Type:Organization
Organization Name:HEALTH CARE PROVIDERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:DEMIDOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:330-533-8490
Mailing Address - Street 1:6674 TIPPECANOE RD STE 1
Mailing Address - Street 2:
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-9149
Mailing Address - Country:US
Mailing Address - Phone:330-533-8490
Mailing Address - Fax:330-533-8783
Practice Address - Street 1:6674 TIPPECANOE RD STE 1
Practice Address - Street 2:
Practice Address - City:CANFIELD
Practice Address - State:OH
Practice Address - Zip Code:44406-9149
Practice Address - Country:US
Practice Address - Phone:330-533-8490
Practice Address - Fax:330-533-8783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-20
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCD0438OtherMEDICARE TRAVELERS
OH0881550Medicaid
9250171Medicare ID - Type Unspecified