Provider Demographics
NPI:1891904199
Name:NORTH CANTON MEDICAL FOUNDATION
Entity Type:Organization
Organization Name:NORTH CANTON MEDICAL FOUNDATION
Other - Org Name:AMHERST MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-433-1200
Mailing Address - Street 1:830 AMHERST RD NE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-8518
Mailing Address - Country:US
Mailing Address - Phone:330-837-6825
Mailing Address - Fax:330-830-3255
Practice Address - Street 1:830 AMHERST RD NE
Practice Address - Street 2:SUITE 201
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-8518
Practice Address - Country:US
Practice Address - Phone:330-837-6825
Practice Address - Fax:330-830-3255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0317310001Medicare PIN