MEDICARE: UNIVERSITY HOSPITALS COORDINATED CARE

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	282N00000X	General Acute Care Hospital		OH

General Provider Information

NPI Number	:	1619243557
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSITY HOSPITALS COORDINATED CARE

Provider Business Mailing Address
First Line	:	3605 WARRENSVILLE CENTER RD
Second Line	:	MAILSTOP MSC 9214
City	:	SHAKER HEIGHTS
State	:	OH
Zip	:	44122-5203
Country	:	US
Telephone Number	:	216-844-3323
Fax Number	:

Provider Business Practice Location Address
First Line	:	3605 WARRENSVILLE CENTER RD
Second Line	:	MAILSTOP MSC 9214
City	:	SHAKER HEIGHTS
State	:	OH
Zip	:	44122-5203
Country	:	US
Telephone Number	:	216-844-3323
Fax Number	:

Authorized Official
Title or Position	:	UHHS DIRECTOR OF REIMBURSEMENT
Name	:	MR. JOHN E TAYLOR
Credential	:
Telephone Number	:	216-767-8793

Provider Enumeration Date	:	03/26/2012
Last Update Date	:	03/26/2012

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