Healthcare Provider Details
I. General information
NPI: 1538176136
Provider Name (Legal Business Name): NORTHEAST OHIO CARDIOVASCULAR SPECIALISTS INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/03/2006
Last Update Date: 10/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
185 W CEDAR ST STE 100
AKRON OH
44307-2441
US
IV. Provider business mailing address
185 W CEDAR ST STE 203
AKRON OH
44307-2447
US
V. Phone/Fax
- Phone: 330-376-0500
- Fax: 330-376-9900
- Phone: 330-376-1500
- Fax: 330-376-5200
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANN
PARKER
Title or Position: CHEIF FINANCIAL OFFICER
Credential: CPA
Phone: 330-376-0500