| Total Lifetime Care Medical Affiliates Inc. | |
|
1 Memory Ln Suite 200 Garrettsville OH 44231-9443 | |
| (330) 527-4852 | |
| (330) 527-4866 |
| Full Name | Total Lifetime Care Medical Affiliates Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 1 Memory Ln, Garrettsville, Ohio |
| Authorized Official Name and Position | Annette L Andrews (OWNER) |
| Authorized Official Contact | 3305274852 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Total Lifetime Care Medical Affiliates Inc. 1 Memory Ln Suite 200 Garrettsville OH 44231-9443 Ph: (330) 527-4852 | Total Lifetime Care Medical Affiliates Inc. 1 Memory Ln Suite 200 Garrettsville OH 44231-9443 Ph: (330) 527-4852 |
| NPI Number | 1932219920 |
|---|---|
| Provider Enumeration Date | 08/30/2006 |
| Last Update Date | 06/18/2021 |
| Medicare PECOS PAC ID | 4486635364 |
|---|---|
| Medicare Enrollment ID | O20040526001261 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932219920 | NPI | - | NPPES |
| 000000141541 | Other | OH | ANTHEM |
| 2395242 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 35057658 (Ohio) | Primary |
| Provider Name | Scott B Smith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568559441 PECOS PAC ID: 8729097530 Enrollment ID: I20060406000015 |
| Provider Name | Todd L Beyer |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1407859275 PECOS PAC ID: 6305829409 Enrollment ID: I20080730000108 |
| Provider Name | Annette Louise Andrews |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154361145 PECOS PAC ID: 2163403056 Enrollment ID: I20100617000459 |
| Provider Name | Robert L Mangeri |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1295966232 PECOS PAC ID: 9931394079 Enrollment ID: I20101115000497 |
| Provider Name | Lonna L. Safko |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851543664 PECOS PAC ID: 1456521038 Enrollment ID: I20110909002708 |
| Provider Name | Marcy L Gonczy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306220363 PECOS PAC ID: 0446553382 Enrollment ID: I20160126002507 |
| Provider Name | Krista Budanov |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861915357 PECOS PAC ID: 8224394747 Enrollment ID: I20171115002864 |
| Provider Name | Kyle Bichler |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1144875519 PECOS PAC ID: 8325471493 Enrollment ID: I20191203001760 |
| Provider Name | Jeffrey Aaron Ellerhorst |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932237039 PECOS PAC ID: 0941573117 Enrollment ID: I20200709001586 |
| Provider Name | Heather Newcomb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477153617 PECOS PAC ID: 7719397108 Enrollment ID: I20201116000172 |
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