Organization
MIDWEST HEALTH SERVICES INC.
Active
Other names
Midwest Health Services Home 1
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSPEH KNETZER (OWNER)
(330) 832-9582
Entity
Organization
Contact information
Practice address
5650 TR 332 STAR RTE, MILLERSBURG, OH 44654
(330) 674-2281
Mailing address
11 LINCOLN WAY W, STE 5A, MASSILLON, OH 44647-6585
(330) 674-2281
(330) 833-7732
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
3810031
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2940492
MEDICAID VENDOR NUMBER
OH
Enumeration date
07/21/2009
Last updated
02/14/2012
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