| Mgh Healthcare, Llc | |
|
321 Niles Cortland Rd Ne Ste B-c Warren OH 44484-1974 | |
| (330) 355-3234 | |
| (330) 975-6343 |
| Full Name | Mgh Healthcare, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 321 Niles Cortland Rd Ne Ste B-c, Warren, Ohio |
| Authorized Official Name and Position | Mary Grace Hall (PRESIDENT/OWNER/PRESCRIBER) |
| Authorized Official Contact | 3303553234 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mgh Healthcare, Llc 321 Niles Cortland Rd Ne Ste B-c Warren OH 44484-1974 Ph: (330) 355-3234 | Mgh Healthcare, Llc 321 Niles Cortland Rd Ne Ste B-c Warren OH 44484-1974 Ph: (330) 355-3234 |
| NPI Number | 1184321341 |
|---|---|
| Provider Enumeration Date | 02/08/2023 |
| Last Update Date | 09/22/2023 |
| Certification Date | 09/22/2023 |
| Medicare PECOS PAC ID | 5193180446 |
|---|---|
| Medicare Enrollment ID | O20230420002244 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184321341 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Mary Grace Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831505577 PECOS PAC ID: 0446573216 Enrollment ID: I20141231000739 |
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