Healthcare Provider Details

I. General information

NPI: 1568410686
Provider Name (Legal Business Name): MOBILE HYPERBARIC CENTERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 06/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 SUPERIOR AVE E STE 2400
CLEVELAND OH
44114-2691
US

IV. Provider business mailing address

600 SUPERIOR AVE E STE 2400
CLEVELAND OH
44114-2691
US

V. Phone/Fax

Practice location:
  • Phone: 216-443-0430
  • Fax: 216-443-0435
Mailing address:
  • Phone: 216-443-0430
  • Fax: 216-443-0435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0005X
TaxonomyUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CHARLES R COWAP
Title or Position: CEO
Credential: MD
Phone: 216-443-0430