1801146394 NPI number — UNIVERSITY HOSPITALS CLEVELAND MEDICAL CENTER

Table of content: (NPI 1801146394)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801146394 NPI number — UNIVERSITY HOSPITALS CLEVELAND MEDICAL CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIVERSITY HOSPITALS CLEVELAND MEDICAL CENTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
UH LYNDHURST SURGERY CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801146394
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/27/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 772930
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DETROIT
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48277-2930
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
216-844-8447
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
29017 CEDAR RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LYNDHURST
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44124-4073
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
216-844-8447
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/12/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SCHILLERO
Authorized Official First Name:
ANTHONY
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR, FP&A
Authorized Official Telephone Number:
216-767-8141

Provider Taxonomy Codes

  • Taxonomy code: 261QM1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 8962421 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: UHLSC . This is a "COMMERCIAL" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".