| Endoscopy Center | |
|
2726 Fulton Dr Nw Canton OH 44718-3506 | |
| (330) 455-5011 | |
| (330) 588-7127 |
| Full Name | Endoscopy Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 2726 Fulton Dr Nw, Canton, Ohio |
| Authorized Official Name and Position | Ana M Theisen (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 3304555011 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Endoscopy Center 2726 Fulton Dr Nw Cantan OH 44718-3506 Ph: (330) 455-5011 | Endoscopy Center 2726 Fulton Dr Nw Canton OH 44718-3506 Ph: (330) 455-5011 |
| NPI Number | 1447231287 |
|---|---|
| Provider Enumeration Date | 11/09/2005 |
| Last Update Date | 01/14/2021 |
| Medicare PECOS PAC ID | 5991604860 |
|---|---|
| Medicare Enrollment ID | O20040108000837 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447231287 | NPI | - | NPPES |
| P00132061 | Other | OH | MEDICARE RAILROAD |
| 0842333 | Medicaid | OH | |
| 000000157479 | Other | OH | ANTHEM BCBS |
| 8467319 | Other | OH | AETNA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 0725AS (Ohio) | Secondary |
| 261QA1903X | Clinic/center - Ambulatory Surgical | (* (Not Available)) | Primary |
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