Healthcare Provider Details

I. General information

NPI: 1376253187
Provider Name (Legal Business Name): DONNA PRICE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2022
Last Update Date: 04/17/2024
Certification Date: 04/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17325 EUCLID AVE STE 4012
CLEVELAND OH
44112-1262
US

IV. Provider business mailing address

12815 HAVANA RD
CLEVELAND OH
44125-5181
US

V. Phone/Fax

Practice location:
  • Phone: 216-438-3349
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: