1972540532 NPI number — CLEVELAND IMAGING AND SURGICAL HOSPITAL, L.L.C.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972540532 NPI number — CLEVELAND IMAGING AND SURGICAL HOSPITAL, L.L.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CLEVELAND IMAGING AND SURGICAL HOSPITAL, L.L.C.
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:
6
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:
1972540532
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/29/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 4247
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77210-4247
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-622-2900
Provider Business Mailing Address Fax Number:
281-659-9732

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1017 S TRAVIS AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLEVELAND
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77327-5152
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-622-2900
Provider Business Practice Location Address Fax Number:
281-659-9732
Provider Enumeration Date:
06/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
FINNEGAN
Authorized Official First Name:
ROBYN
Authorized Official Middle Name:
M
Authorized Official Title or Position:
VICE PRESIDENT MANAGED CARE
Authorized Official Telephone Number:
513-454-1428

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  008404 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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