1316109382 NPI number — JOSHUA MEIR BEN-AMOZ R.PH., C.N.

Table of content: JOSHUA MEIR BEN-AMOZ R.PH., C.N. (NPI 1316109382)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316109382 NPI number — JOSHUA MEIR BEN-AMOZ R.PH., C.N.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BEN-AMOZ
Provider First Name:
JOSHUA
Provider Middle Name:
MEIR
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
R.PH., C.N.
Provider Gender Code:
M

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:
1316109382
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/12/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
198 RAYMOND AVE NW APT B
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WARREN
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44483-7116
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-240-8373
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10764 NORTH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GARRETTSVILLE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44231-1016
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-527-2828
Provider Business Practice Location Address Fax Number:
330-527-2738
Provider Enumeration Date:
06/30/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  PS38312 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 183500000X , with the licence number: 03129939 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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