Provider Demographics
NPI:1063271906
Name:ARMSTRONG, MARK ANTHONY II
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:ANTHONY
Last Name:ARMSTRONG
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1302 EDGEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:STREETSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:44241-6604
Mailing Address - Country:US
Mailing Address - Phone:216-409-2081
Mailing Address - Fax:
Practice Address - Street 1:1302 EDGEWOOD LN
Practice Address - Street 2:
Practice Address - City:STREETSBORO
Practice Address - State:OH
Practice Address - Zip Code:44241-6604
Practice Address - Country:US
Practice Address - Phone:216-409-2081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-14
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
No374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker