1770698466 NPI number — CHILDREN'S CARE CENTER FOR BLOOD & CANCER

Table of content: MS. CHARLOTTE ELAINE SHERMAN CRNA (NPI 1376634485)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770698466 NPI number — CHILDREN'S CARE CENTER FOR BLOOD & CANCER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHILDREN'S CARE CENTER FOR BLOOD & CANCER
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:
1770698466
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
500 GYPSY LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
YOUNGSTOWN
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44504-1315
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-884-3955
Provider Business Mailing Address Fax Number:
330-884-3861

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
500 GYPSY LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YOUNGSTOWN
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44504-1315
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-884-3955
Provider Business Practice Location Address Fax Number:
330-884-3861
Provider Enumeration Date:
08/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SALEH
Authorized Official First Name:
LUCINE
Authorized Official Middle Name:
Authorized Official Title or Position:
BUSINESS MANAGER
Authorized Official Telephone Number:
330-884-3955

Provider Taxonomy Codes

  • Taxonomy code: 2080P0207X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0892388 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com