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NPI Code Detail

MEDICARE: NEPHROLOGY ASSOCIATES OF CLEVELAND LTD.

MEDICARE: NEPHROLOGY ASSOCIATES OF CLEVELAND LTD.
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
1261QE0700XEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center0459DCOH

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 : 1376630087
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEPHROLOGY ASSOCIATES OF CLEVELAND LTD.
Provider Business Mailing Address
First Line : 18720 CHAGRIN BLVD
Second Line :
City : SHAKER HEIGHTS
State : OH
Zip : 44122-4855
Country : US
Telephone Number : 216-295-7003
Fax Number : 216-295-7014
Provider Business Practice Location Address
First Line : 25301 EUCLID AVE
Second Line :
City : EUCLID
State : OH
Zip : 44117-2609
Country : US
Telephone Number : 216-732-3750
Fax Number : 216-732-3760
Authorized Official
Title or Position : COO
Name : GAYLE A NEMECEK
Credential :
Telephone Number : 216-658-0458
Provider Enumeration Date : 10/06/2006
Last Update Date : 03/03/2025

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