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NPI Code Detail

MEDICARE: THE PATRICIAN INC.

MEDICARE: THE PATRICIAN INC.
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
1314000000XSkilled Nursing Facility3073OH

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 : 1871591230
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE PATRICIAN INC.
Provider Business Mailing Address
First Line : 1026 PEARL RD
Second Line : SUITE #5
City : BRUNSWICK
State : OH
Zip : 44212-2516
Country : US
Telephone Number : 330-225-8054
Fax Number : 330-225-9094
Provider Business Practice Location Address
First Line : 9001 W 130TH ST
Second Line :
City : NORTH ROYALTON
State : OH
Zip : 44133-1011
Country : US
Telephone Number : 440-237-3104
Fax Number : 440-237-6730
Authorized Official
Title or Position : PRESIDENT
Name : MRS. DOULA GAITANAROS
Credential :
Telephone Number : 330-225-8054
Provider Enumeration Date : 07/11/2005
Last Update Date : 07/27/2007

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Directions to “THE PATRICIAN INC. ” Practice Location

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