Provider Demographics
NPI:1053170761
Name:ARI CARE PEDIATRIC SERVICES
Entity type:Organization
Organization Name:ARI CARE PEDIATRIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:G
Authorized Official - Last Name:GATEWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:440-251-1854
Mailing Address - Street 1:664 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:PAINESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44077-3661
Mailing Address - Country:US
Mailing Address - Phone:440-251-1854
Mailing Address - Fax:
Practice Address - Street 1:664 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:PAINESVILLE
Practice Address - State:OH
Practice Address - Zip Code:44077-3661
Practice Address - Country:US
Practice Address - Phone:440-251-1854
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-15
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care