1598738718 NPI number — CLEVELAND CLINIC HOME CARE SERVICES

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 1598738718 NPI number — CLEVELAND CLINIC HOME CARE SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CLEVELAND CLINIC HOME CARE SERVICES
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:
HOSPICE OF THE CLEVELAND CLINIC
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:
1598738718
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/07/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 931664
Provider Second Line Business Mailing Address:
HOSPICE OF CLEVELAND CLINIC
Provider Business Mailing Address City Name:
CLEVELAND
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44193-1777
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
216-444-9819
Provider Business Mailing Address Fax Number:
216-520-1973

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6801 BRECKSVILLE RD
Provider Second Line Business Practice Location Address:
SUITE # 10 ATTN: ADMINISTRATOR/DIRECTOR
Provider Business Practice Location Address City Name:
INDEPENDENCE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44131-5032
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
216-444-9819
Provider Business Practice Location Address Fax Number:
216-520-1973
Provider Enumeration Date:
02/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ONLAYAO
Authorized Official First Name:
ELIZABETH
Authorized Official Middle Name:
P.
Authorized Official Title or Position:
MANAGER, REIMBURSEMENT
Authorized Official Telephone Number:
216-636-8812

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0850575 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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