Provider Demographics
NPI:1174228415
Name:PAPACOSTAS, ALEXANDRIA GEORGIANNA (CMA, AAMA HHA)
Entity type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:GEORGIANNA
Last Name:PAPACOSTAS
Suffix:
Gender:F
Credentials:CMA, AAMA HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 CLARENDON AVE NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44708-4646
Mailing Address - Country:US
Mailing Address - Phone:234-322-4757
Mailing Address - Fax:
Practice Address - Street 1:127 CLARENDON AVE NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-4646
Practice Address - Country:US
Practice Address - Phone:234-322-4757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-04
Last Update Date:2025-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No332U00000XSuppliersHome Delivered Meals
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0029248Medicaid