1588273825 NPI number — TREMONT FUNCTIONAL REHAB

Table of content: (NPI 1588273825)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588273825 NPI number — TREMONT FUNCTIONAL REHAB

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TREMONT FUNCTIONAL REHAB
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:
1588273825
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/27/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 64
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RICHFIELD
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44286-0064
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
216-904-6670
Provider Business Mailing Address Fax Number:
216-586-6780

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2401 SCRANTON RD
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:
44113-4313
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
216-356-6030
Provider Business Practice Location Address Fax Number:
216-586-6780
Provider Enumeration Date:
07/22/2020

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
FRANTZIS
Authorized Official First Name:
ALEXIS
Authorized Official Middle Name:
Authorized Official Title or Position:
MEMBER
Authorized Official Telephone Number:
216-721-9010

Provider Taxonomy Codes

  • Taxonomy code: 111NX0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QP2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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