| Canton Family Healthcare Llc | |
|
4590 Dressler Rd Nw Canton OH 44718-2546 | |
| (330) 484-1607 | |
| (330) 484-2943 |
| Full Name | Canton Family Healthcare Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4590 Dressler Rd Nw, Canton, Ohio |
| Authorized Official Name and Position | Maria Angelica Marasigan Lupisan (OFFICE MANAGER) |
| Authorized Official Contact | 3304841607 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Canton Family Healthcare Llc 4590 Dressler Rd Nw Canton OH 44718-2546 Ph: (330) 484-1607 | Canton Family Healthcare Llc 4590 Dressler Rd Nw Canton OH 44718-2546 Ph: (330) 484-1607 |
| NPI Number | 1235671926 |
|---|---|
| Provider Enumeration Date | 11/11/2016 |
| Last Update Date | 08/17/2022 |
| Medicare PECOS PAC ID | 6305128307 |
|---|---|
| Medicare Enrollment ID | O20170127001045 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235671926 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Kerwin Joel A Lupisan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700104619 PECOS PAC ID: 6608194907 Enrollment ID: I20150417000326 |
| Provider Name | Maria Angelica Marasigan Lupisan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437737566 PECOS PAC ID: 8022390020 Enrollment ID: I20210504001023 |
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