PHYSICIAN MANAGEMENT SERVICES OF OHIO LLC NPI 1144533407

NPI Information

  • NPI: 1144533407
  • Provider Name: PHYSICIAN MANAGEMENT SERVICES OF OHIO LLC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Former Legal Business Name: VAXCARE OHIO LLC
  • CLIA Number: 36D1069328
  • Address: 211 15TH ST NW
    CANTON, OH
    ZIP 44703
  • Phone: (888) 829-8550

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NPI Details

PHYSICIAN MANAGEMENT SERVICES OF OHIO LLC is a family medicine in Canton, OH. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. PHYSICIAN MANAGEMENT SERVICES OF OHIO LLC NPI is 1144533407. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Vaxcare Ohio Llc.

The provider's business location address is:

211 15TH ST NW
CANTON, OH
ZIP 44703-704
Phone: (888) 829-8550

The provider's authorized official is Casey Deloach .
The authorized official title is President and has the following contact phone number (888) 829-8550.

The CLIA number assigned to this NPI record is 36D1069328 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/15/2010 and was last updated on 10/21/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1PHC059OTHERMEDICARE PTAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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