WARREN GASTRO ENDOSCOPY CTR INC NPI 1396738936

NPI Information

NPI: 1396738936
Provider Name: WARREN GASTRO ENDOSCOPY CTR INC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 36D0941261

Address:
1622 E MARKET ST
WARREN, OH
ZIP 44483
Phone: (330) 399-7215
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WARREN GASTRO ENDOSCOPY CTR INC is an ambulatory surgical clinic center in Warren, OH. WARREN GASTRO ENDOSCOPY CTR INC NPI is 1396738936. The provider is registered as an organization entity type.

The provider's business location address is:

1622 E MARKET ST
WARREN, OH
ZIP 44483-613
Phone: (330) 399-7215
Fax: (330) 399-2411

The provider's authorized official is Adel I Youssef .
The authorized official title is President and has the following contact phone number (330) 399-7215.

The CLIA number assigned to this NPI record is 36D0941261 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/30/2005 and was last updated on 5/6/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical	346 0335AS	OHIO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	2078719	MEDICAID	OHIO
2	000000157529	OTHER	OHIO	ANTHEM PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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