MEDICARE: GOLDEN CIPHERS

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
1	251V00000X	Voluntary or Charitable Agency

General Provider Information

NPI Number	:	1194778092
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLDEN CIPHERS

Provider Business Mailing Address
First Line	:	3337 CENTRAL AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44115-3022
Country	:	US
Telephone Number	:	216-687-0000
Fax Number	:	216-687-9187

Provider Business Practice Location Address
First Line	:	2320 E 24TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44115-3112
Country	:	US
Telephone Number	:	216-687-0000
Fax Number	:	216-687-9187

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MRS. PAMELA MONIQUE HUBBARD
Credential	:	OCPSII
Telephone Number	:	216-687-0000

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	08/22/2020

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