| Mrs Anita R Koch, RN CNS | |
|
7067 Tiffany Blvd, Suite 230, Poland, OH 44514-1993 | |
| (330) 758-2748 | |
| (330) 758-3282 |
| Full Name | Mrs Anita R Koch |
|---|---|
| Gender | Female |
| Speciality | Certified Clinical Nurse Specialist (cns) |
| Experience | 19 Years |
| Location | 7067 Tiffany Blvd, Poland, Ohio |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316190556 | NPI | - | NPPES |
| 000000955776 | Other | OH | ANTHEM BSBS |
| 2916518 | Medicaid | OH | |
| H155462 | Other | OH | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163W00000X | Registered Nurse | RN. 226436 (Ohio) | Secondary |
| 364SA2200X | Clinical Nurse Specialist - Adult Health | NS09826 (Ohio) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Surgical Hospital At Southwoods | Youngstown, OH | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Triad Health Services Llc | 9032367917 | 226 |
| Entity Name | Bel-park Anesthesia Associates, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1508813528 PECOS PAC ID: 8628974904 Enrollment ID: O20031209000067 |
| Entity Name | Triad Health Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1588925457 PECOS PAC ID: 9032367917 Enrollment ID: O20120918000787 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Anita R Koch, RN CNS 4135 Boardman Canfield Rd, Suite 101, Canfield, OH 44406-9803 Ph: (330) 286-5330 | Mrs Anita R Koch, RN CNS 7067 Tiffany Blvd, Suite 230, Poland, OH 44514-1993 Ph: (330) 758-2748 |
Frank Aaron Gargasz, CNS Clinical Nurse Specialist Medicare: Accepting Medicare Assignments Practice Location: 905 Sahara Trl, Poland, OH 44514 Phone: 330-729-8970 Fax: 330-729-8971 | |
Patricia Ratliff, CNS Clinical Nurse Specialist Medicare: Accepting Medicare Assignments Practice Location: 3304 Stones Throw Ave, Poland, OH 44514 Phone: 330-707-1116 Fax: 330-707-1119 | |
Tina Marie Femia, CNS Clinical Nurse Specialist Medicare: Accepting Medicare Assignments Practice Location: 715 E Western Reserve Rd Fl 2, Poland, OH 44514 Phone: 330-965-8157 Fax: 330-965-5684 |