Provider Demographics
NPI:1285712307
Name:FIRESTONE HEALTH CARE INC
Entity type:Organization
Organization Name:FIRESTONE HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:D
Authorized Official - Last Name:VRABLE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:330-426-9484
Mailing Address - Street 1:PO BOX 429
Mailing Address - Street 2:132 NORTH MARKET STREET
Mailing Address - City:EAST PALESTINE
Mailing Address - State:OH
Mailing Address - Zip Code:44413
Mailing Address - Country:US
Mailing Address - Phone:330-426-9484
Mailing Address - Fax:330-426-2248
Practice Address - Street 1:2364 SOUTHEAST BLVD
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OH
Practice Address - Zip Code:44460
Practice Address - Country:US
Practice Address - Phone:330-332-4833
Practice Address - Fax:330-332-8220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2219307Medicaid
OH9269143Medicare ID - Type Unspecified