Basic Information
| Provider Information | |||||||||
| NPI: | 1699700823 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PIONEER PHYSICIANS NETWORK, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3515 MASSILLON RD SUITE 300 | ||||||||
| Address2: | |||||||||
| City: | UNIONTOWN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 446857819 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3308999350 | ||||||||
| FaxNumber: | 3308999395 | ||||||||
| Practice Location | |||||||||
| Address1: | 3300 GREENWICH RD | ||||||||
| Address2: | SUITE 8 | ||||||||
| City: | NORTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 442035714 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3308257371 | ||||||||
| FaxNumber: | 3308257473 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/12/2006 | ||||||||
| LastUpdateDate: | 08/14/2020 | ||||||||
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| AuthorizedOfficialLastName: | KOSTELNICK | ||||||||
| AuthorizedOfficialFirstName: | KATHLEEN | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | PRACTICE ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 3308999350 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 08/14/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
No ID Information.