| Carroll Family Healthcare | |
|
635 Locust St Malvern OH 44644 | |
| (330) 863-9061 | |
| (330) 863-6492 |
| Full Name | Carroll Family Healthcare |
|---|---|
| Speciality | Clinic/Center |
| Location | 635 Locust St, Malvern, Ohio |
| Authorized Official Name and Position | Tanya L Smith (OFFICE MANAGER) |
| Authorized Official Contact | 3308639061 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carroll Family Healthcare 635 Locust Street Malvern OH 44644 Ph: (330) 863-9061 | Carroll Family Healthcare 635 Locust St Malvern OH 44644 Ph: (330) 863-9061 |
| NPI Number | 1235221169 |
|---|---|
| Provider Enumeration Date | 09/28/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 0345267431 |
|---|---|
| Medicare Enrollment ID | O20051027001109 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235221169 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Steven R Stasiak |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336128289 PECOS PAC ID: 4789601873 Enrollment ID: I20051027001124 |
| Provider Name | Joni Marie Stasiak |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245219187 PECOS PAC ID: 9335323054 Enrollment ID: I20110405000182 |