Provider Demographics
NPI:1831357771
Name:MCQUAIN, JANENE S
Entity type:Individual
Prefix:
First Name:JANENE
Middle Name:S
Last Name:MCQUAIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 MALACCA ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44305-3659
Mailing Address - Country:US
Mailing Address - Phone:330-794-2744
Mailing Address - Fax:
Practice Address - Street 1:375 MALACCA ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44305-3659
Practice Address - Country:US
Practice Address - Phone:330-794-2744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-28
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2480453Medicaid