Provider Demographics
NPI:1487713632
Name:EDWARD N. BARR
Entity type:Organization
Organization Name:EDWARD N. BARR
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:BARR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-868-6044
Mailing Address - Street 1:1028 E LINCOLNWAY
Mailing Address - Street 2:
Mailing Address - City:MINERVA
Mailing Address - State:OH
Mailing Address - Zip Code:44657-1216
Mailing Address - Country:US
Mailing Address - Phone:330-868-6044
Mailing Address - Fax:
Practice Address - Street 1:1028 E LINCOLNWAY
Practice Address - Street 2:
Practice Address - City:MINERVA
Practice Address - State:OH
Practice Address - Zip Code:44657-1216
Practice Address - Country:US
Practice Address - Phone:330-868-6044
Practice Address - Fax:330-868-6847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9266751Medicare ID - Type Unspecified