Provider Demographics
NPI:1831957414
Name:STARK PAIN MANAGEMENT LLC
Entity type:Organization
Organization Name:STARK PAIN MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:FREDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SARIF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-623-7100
Mailing Address - Street 1:6659 FRANK AVE NW
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-7259
Mailing Address - Country:US
Mailing Address - Phone:330-623-7100
Mailing Address - Fax:330-232-9924
Practice Address - Street 1:6659 FRANK AVE NW
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-7259
Practice Address - Country:US
Practice Address - Phone:330-623-7100
Practice Address - Fax:330-232-9924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-08
Last Update Date:2024-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction MedicineGroup - Multi-Specialty