Provider Demographics
NPI:1972624377
Name:WARREN CITY AUDITOR
Entity Type:Organization
Organization Name:WARREN CITY AUDITOR
Other - Org Name:WARREN CITY NURSING CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:DEPUTY HEALTH COMMISSIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:R
Authorized Official - Last Name:PINTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-841-2596
Mailing Address - Street 1:258 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44481-1203
Mailing Address - Country:US
Mailing Address - Phone:330-841-2596
Mailing Address - Fax:330-841-2911
Practice Address - Street 1:258 E MARKET ST
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44481
Practice Address - Country:US
Practice Address - Phone:330-841-2596
Practice Address - Fax:330-841-2911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0741228Medicaid
OHFV91421Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER