Healthcare Provider Details

I. General information

NPI: 1962566430
Provider Name (Legal Business Name): VILLAGE OF MORELAND HILLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 05/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 W WASHINGTON ST
CHAGRIN FALLS OH
44022-3010
US

IV. Provider business mailing address

21 W WASHINGTON ST
CHAGRIN FALLS OH
44022-3010
US

V. Phone/Fax

Practice location:
  • Phone: 440-247-8271
  • Fax:
Mailing address:
  • Phone: 440-247-8271
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State

VIII. Authorized Official

Name: PRASHANT SHAH
Title or Position: TREASURER
Credential:
Phone: 440-247-8271