Organization Name:  WARREN GASTRO ENDOSCOPY CTR INC


Practice Location:
1622 E MARKET ST  WARREN, OH 44483 US
Tel: 330-399-7215  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

Primary	Code	Category/Description	State	License Number
Y	261QA1903X	Ambulatory Health Care Facilities Clinic/Center Ambulatory Surgical	OH	346 0335AS

Other Provider Identifiers:

Issuer	Number	State	Type
	2078719	OH	05
ANTHEM PIN	000000157529	OH	01

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin