Provider Demographics
NPI:1770714586
Name:FORUM HEALTH SERVICES CO.
Entity type:Organization
Organization Name:FORUM HEALTH SERVICES CO.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT/COO FORUM HEALTH SRV
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SEELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-884-5858
Mailing Address - Street 1:20 OHLTOWN RD
Mailing Address - Street 2:
Mailing Address - City:AUSTINTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-2331
Mailing Address - Country:US
Mailing Address - Phone:330-884-1500
Mailing Address - Fax:330-884-1501
Practice Address - Street 1:730 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HUBBARD
Practice Address - State:OH
Practice Address - Zip Code:44425-1126
Practice Address - Country:US
Practice Address - Phone:330-884-1500
Practice Address - Fax:330-884-1501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-29
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine