OHIO NORTH EAST HEALTH SYSTEMS, INC (LLOYD MCCOY HEALTH CENTER) - NPI NUMBER 1942504089

Summary

Provider Name: OHIO NORTH EAST HEALTH SYSTEMS, INC (LLOYD MCCOY HEALTH CENTER)

NPI Number: 1942504089

Clasification: Clinic/Center (261Q00000X)

Address:
1977 NILES RD SE
WARREN, OH
ZIP 44484

Phone Number: (330) 393-6446



Detailed Information

OHIO NORTH EAST HEALTH SYSTEMS, INC is a clinic/center in Warren, OH. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). The assigned NPI number for this provider is 1942504089 and is registered as an organization entity type.
The provider Other Name Is Lloyd Mccoy Health Center.

The provider's business address is:

1977 NILES RD SE
WARREN, OH
ZIP 44484-118
Phone: (330) 393-6446

The provider's authorized official is Ronald Dwinnells .
The authorized official title is Ceo and has the following contact phone number (330) 747-2330.

The enumeration date for this NPI number is 1/4/2011 and was last updated on 1/4/2011.

Map - Location of Practice

Taxonomy Codes

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 261Q00000X Clinic/Center OH Yes

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1942504089 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 2 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Employer Identification Number EIN The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
4 Provider Organization Name Legal Business Name OHIO NORTH EAST HEALTH SYSTEMS, INC The name of the organization provider. If the provider is an organization, this is the legal business name.
5 Provider Other Organization Name LLOYD MCCOY HEALTH CENTER Other name by which the organization provider is or has been known.
6 Provider Other Organization Name Type Code 5 Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
7 Provider First Line Business Practice Location Address 1977 NILES RD SE The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
8 Provider Business Practice Location Address City Name WARREN The city name in the location address of the provider being identified.
9 Provider Business Practice Location Address State Name OH The State code in the location of the provider being identified.
10 Provider Business Practice Location Address Postal Code 444845118 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
11 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
12 Provider Business Practice Location Address Telephone Number 3303936446 The telephone number associated with the location address of the provider being identified.
13 Provider Enumeration Date 1/4/2011 The date the provider was assigned a unique identifier (assigned an NPI).
14 Last Update Date 1/4/2011 The date that a record was last updated or changed.
15 Authorized Official Last Name DWINNELLS The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
16 Authorized Official First Name RONALD The first name of the authorized official.
17 Authorized Official Title or Position CEO The title or position of the authorized official.
18 Authorized Official Telephone Number 3307472330 The 10-position telephone number of the authorized official.
19 Healthcare Provider Taxonomy Code 1 261Q00000X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
20 Provider License Number State Code 1 OH The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
21 Healthcare Provider Primary Taxonomy Switch 1 Y
22 Is Organization Subpart N
23 Authorized Official Name Prefix Text DR.
24 Authorized Official Credential Text M.D.

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This page was last updated on: 4/19/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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