1023234069 NPI number — RAMI N. HACHWI, M.D., INC.

Table of content: (NPI 1023234069)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023234069 NPI number — RAMI N. HACHWI, M.D., INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RAMI N. HACHWI, M.D., INC.
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:
Provider Other Organization Name Type Code:
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:
1023234069
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/21/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 451184
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WESTLAKE
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44145-0630
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
216-889-9088
Provider Business Mailing Address Fax Number:
216-889-9205

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
18099 LORAIN AVE STE 308
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLEVELAND
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44111-5611
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
216-889-9088
Provider Business Practice Location Address Fax Number:
216-889-9205
Provider Enumeration Date:
04/18/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HACHWI
Authorized Official First Name:
RAMI
Authorized Official Middle Name:
N
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
216-889-9088

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  35-084277 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2475450 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2879336 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".