Provider Demographics
NPI:1205692498
Name:SALEM FAMILY CARE LLC
Entity type:Organization
Organization Name:SALEM FAMILY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:P
Authorized Official - Last Name:WHITEHILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-639-0880
Mailing Address - Street 1:718 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OH
Mailing Address - Zip Code:44460-2915
Mailing Address - Country:US
Mailing Address - Phone:330-639-0880
Mailing Address - Fax:330-639-0880
Practice Address - Street 1:718 E 3RD ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OH
Practice Address - Zip Code:44460-2915
Practice Address - Country:US
Practice Address - Phone:330-639-0880
Practice Address - Fax:330-639-0880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty