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Organization
MIDWEST HEALTH SERVICES INC.
Active
Organization
MIDWEST HEALTH SERVICES INC.
Active
Other names
Midwest Health Services Home 3
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH KNETZER (OWNER)
(330) 832-9582
Entity
Organization
Contact information
Practice address
1620 FOREST AVE SE, MASSILLON, OH 44646-8330
(330) 832-2797
Mailing address
11 LINCOLN WAY W, STE 5A, MASSILLON, OH 44647-6585
(330) 832-9582
(330) 833-7732
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
7610740
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2940474
MEDICAID VENDOR NUMBER
OH
Enumeration date
07/22/2009
Last updated
02/14/2012
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