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NPI Code Detail

MEDICARE: EASTSIDE MULTI-CARE INC

MEDICARE: EASTSIDE MULTI-CARE INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1313M00000XNursing Facility/Intermediate Care Facility
2314000000XSkilled Nursing Facility5477OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1063402451
Entity Type Code : Organization
Provider Name (Legal Business Name) : EASTSIDE MULTI-CARE INC
Provider Business Mailing Address
First Line : 19900 CLARE AVE
Second Line :
City : MAPLE HTS
State : OH
Zip : 44137-1806
Country : US
Telephone Number : 216-662-3343
Fax Number : 216-662-1887
Provider Business Practice Location Address
First Line : 19900 CLARE AVE
Second Line :
City : MAPLE HTS
State : OH
Zip : 44137-1806
Country : US
Telephone Number : 216-662-3343
Fax Number : 216-662-1887
Authorized Official
Title or Position : ADMINISTRATOR
Name : ANGELA D HAMMONS
Credential : LNHA
Telephone Number : 216-662-3343
Provider Enumeration Date : 10/26/2005
Last Update Date : 02/16/2011

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Directions to “EASTSIDE MULTI-CARE INC ” Practice Location

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