Organization
MEP OBSERVATION SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER CHASTAIN (PROVIDER ENROLLMENT)
(330) 493-4443
Entity
Organization
Contact information
Practice address
12500 WILLOWBROOK RD, CUMBERLAND, MD 21502-6393
(330) 493-4443
Mailing address
4535 DRESSLER RD NW, CANTON, OH 44718-2545
(330) 493-4443
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
07/19/2011
Last updated
12/18/2024
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