MEDICARE: THE METROHEALTH SYSTEM

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	1223P0106X	Oral and Maxillofacial Pathology Dentistry
2	1223P0221X	Pediatric Dentistry
3	1223E0200X	Endodontics
4	1223P0300X	Periodontics
5	1223P0700X	Prosthodontics
6	1223G0001X	General Practice Dentistry
7	1223S0112X	Oral and Maxillofacial Surgery (Dentist)
8	1223X0008X	Oral and Maxillofacial Radiology Dentistry
9	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry
10	122400000X	Denturist
11	124Q00000X	Dental Hygienist
12	126800000X	Dental Assistant
13	126900000X	Dental Laboratory Technician
14	1223D0001X	Public Health Dentistry
15	122300000X	Dentist

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CA1240	OTHER	OH	RAIL ROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1346282324
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE METROHEALTH SYSTEM

Provider Business Mailing Address
First Line	:	4229 PEARL RD
Second Line	:	ATTN: LINDA GREENHILL PFS SVR RM 2-20-20
City	:	CLEVELAND
State	:	OH
Zip	:	44109-4218
Country	:	US
Telephone Number	:	216-957-2442
Fax Number	:	216-957-2404

Provider Business Practice Location Address
First Line	:	3701 LORAIN AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44113-3707
Country	:	US
Telephone Number	:	216-778-8046
Fax Number	:	216-957-4801

Authorized Official
Title or Position	:	EVP/CFO
Name	:	MR. DERRICK HOLLINGS
Credential	:
Telephone Number	:	216-778-7800

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	05/09/2024

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Directions to “THE METROHEALTH SYSTEM ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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