Healthcare Provider Details

I. General information

NPI: 1114267663
Provider Name (Legal Business Name): PROFESSIONAL MEDICAL SERVICES, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2013
Last Update Date: 02/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16910 HARVARD AVE
CLEVELAND OH
44128-2210
US

IV. Provider business mailing address

16910 HARVARD AVE
CLEVELAND OH
44128-2210
US

V. Phone/Fax

Practice location:
  • Phone: 216-645-4070
  • Fax:
Mailing address:
  • Phone: 216-645-4070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateOH
# 4
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. ABULIME ALLI
Title or Position: OWNER
Credential:
Phone: 216-645-4070