DOCTORS PAIN CENTER, LLC; NPI #1386698215

Contact Information

DOCTORS PAIN CENTER, LLC

1011 BOARDMAN CANFIELD RD
BOARDMAN, OH 44512

Phone: 330-629-2888
Fax: 330-259-9625
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Pain Medicine	207LP2900X	05	Physician/Anesthesiology
Addiction (Substance Use Disorder)	101YA0400X
Anesthesiology	207L00000X	79	Physician/Addiction Medicine
Clinical	1041C0700X	80	Licensed Clinical Social Worker
Mental Health	101YM0800X
Pain Medicine	2081P2900X	25	Physician/Physical Medicine and Rehabilitation
Professional	101YP2500X
Psychiatric/Mental Health	364SP0808X	89	Certified Clinical Nurse Specialist

Indicates primary specialty

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NPI Profile & details for DOCTORS PAIN CENTER, LLC

NPI # 1386698215

LBN Legal business name DOCTORS PAIN CENTER, LLC

Authorized official TRACY NEUENDORF - (PRESIDENT/CEO/OWNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 05/22/2006

Last updated 08/21/2018 - About 8 years ago

Identifiers

OH	Medicaid	2469154
PA	Medicaid	1018803700001
PA	Medicaid	2462154
OH	Other	340892	ANTHEM
PA	Other	111998	HIGHMARK
PA	Other	1954815	HIGHMARK BC/BS

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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DOCTORS PAIN CENTER, LLC

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NPI Profile & details for DOCTORS PAIN CENTER, LLC

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