| Maguire Medical Llc | |
|
2055 Alexandria Way Macedonia OH 44056-1998 | |
| (330) 468-3312 | |
| (330) 468-0602 |
| Full Name | Maguire Medical Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2055 Alexandria Way, Macedonia, Ohio |
| Authorized Official Name and Position | Thomas M Maguire (TAX ID OWNER) |
| Authorized Official Contact | 3304683312 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Maguire Medical Llc 2055 Alexandria Way Macedonia OH 44056-1998 Ph: (330) 468-3312 | Maguire Medical Llc 2055 Alexandria Way Macedonia OH 44056-1998 Ph: (330) 468-3312 |
| NPI Number | 1700397775 |
|---|---|
| Provider Enumeration Date | 10/18/2017 |
| Last Update Date | 10/18/2017 |
| Medicare PECOS PAC ID | 4486912920 |
|---|---|
| Medicare Enrollment ID | O20171211001714 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700397775 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Ohio) | Primary |
| 207R00000X | Internal Medicine | (Ohio) | Secondary |
| Provider Name | Thomas M Maguire |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457339665 PECOS PAC ID: 9931285517 Enrollment ID: I20080324000228 |
| Provider Name | Samantha Deramo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669892139 PECOS PAC ID: 2466678032 Enrollment ID: I20200217002305 |