| Organization Name: | WARREN FAMILY MEDICAL, INC. |
| NPI Number: | 1013106467 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | FAREEDAH ZAKIYYAH GOODWIN (PRESIDENT) |
| Mailing Address: | 8700 E Market St Suite 4 Warren |
| State: | OH US |
| Postal Code: | 444842340 |
| Phone Number: | 3308567702 |
| Fax Number: | |
| NPI Enumeration Date: | 10/22/2007 |
| NPI Last Update Date: | 01/12/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QH0100X |
| License Number: | 85291 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Health Service |
| Taxonomy Definition: | |