Healthcare Provider Details

I. General information

NPI: 1609845593
Provider Name (Legal Business Name): W.R. CATERING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12550 CHILLICOTHE RD
CHESTERLAND OH
44026-2560
US

IV. Provider business mailing address

11642 AQUILLA RD
CHARDON OH
44024-7927
US

V. Phone/Fax

Practice location:
  • Phone: 440-729-6800
  • Fax: 866-319-5481
Mailing address:
  • Phone: 440-635-0202
  • Fax: 866-319-5481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number2210799
License Number StateOH

VIII. Authorized Official

Name: FRANK G CARLSON
Title or Position: PRESIDENT /OWNER
Credential: R.T. B.A.
Phone: 440-729-6800