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NPI Code Detail

MEDICARE: MR. GARTH LEE IRELAND RN CNS

MEDICARE: MR. GARTH LEE IRELAND RN CNS
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
1163W00000XRegistered NurseRN273708OH

General Provider Information

NPI Number : 1730386251
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. GARTH LEE IRELAND RN CNS
Provider Business Mailing Address
First Line : 1930 S BELVOIR BLVD
Second Line :
City : SOUTH EUCLID
State : OH
Zip : 44121-3748
Country : US
Telephone Number : 216-291-8727
Fax Number : 216-291-2115
Provider Business Practice Location Address
First Line : 11100 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44106-1716
Country : US
Telephone Number : 216-844-7062
Fax Number : 216-844-1640
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2007
Last Update Date : 07/08/2007

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