Basic Information
| Provider Information | |||||||||
| NPI: | 1376595538 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PARAGON HEALTH ASSOCIATES, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 51 PARK WEST BLVD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | AKRON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 443204215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3308699777 | ||||||||
| FaxNumber: | 3308656011 | ||||||||
| Practice Location | |||||||||
| Address1: | 51 PARK WEST BLVD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | AKRON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 443204215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3308699777 | ||||||||
| FaxNumber: | 3308656011 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/16/2006 | ||||||||
| LastUpdateDate: | 01/29/2015 | ||||||||
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| AuthorizedOfficialLastName: | ALESTOCK | ||||||||
| AuthorizedOfficialFirstName: | NAOMI | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | ADMINISTRATIVE ASSISTANT | ||||||||
| AuthorizedOfficialTelephone: | 3308699777 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 2630764 | 05 | OH | MEDICAID |