Healthcare Provider Details

I. General information

NPI: 1023439981
Provider Name (Legal Business Name): EMERGENCY PROFESSIONAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2013
Last Update Date: 12/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2351 E 22ND ST
CLEVELAND OH
44115-3111
US

IV. Provider business mailing address

7123 PEARL RD STE 201
CLEVELAND OH
44130-4944
US

V. Phone/Fax

Practice location:
  • Phone: 216-861-6200
  • Fax:
Mailing address:
  • Phone: 440-842-7990
  • Fax: 440-842-8835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146D00000X
TaxonomyPersonal Emergency Response Attendant
License Number50003853
License Number StateOH

VIII. Authorized Official

Name: LAUREL L DOLLISON
Title or Position: CEO
Credential: DO
Phone: 440-842-7990