1679676241 NPI number — YANKE BIONICS INC

Table of content: (NPI 1679676241)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679676241 NPI number — YANKE BIONICS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
YANKE BIONICS INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1679676241
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/07/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
303 W EXCHANGE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AKRON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44302
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-762-6411
Provider Business Mailing Address Fax Number:
330-762-4110

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4694 W TUSCARAWAS ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CANTON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44708
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-479-9662
Provider Business Practice Location Address Fax Number:
330-479-9716
Provider Enumeration Date:
09/07/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
YANKE
Authorized Official First Name:
MARK
Authorized Official Middle Name:
J
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
330-762-6411

Provider Taxonomy Codes

  • Taxonomy code: 335E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000155804 . This is a "ANTHEM BCBS" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 6616880 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".