Healthcare Provider Details

I. General information

NPI: 1437657236
Provider Name (Legal Business Name): CIRCLE HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2018
Last Update Date: 02/12/2020
Certification Date: 02/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12201 EUCLID AVE
CLEVELAND OH
44106-4310
US

IV. Provider business mailing address

4500 EUCLID AVE
CLEVELAND OH
44103-3736
US

V. Phone/Fax

Practice location:
  • Phone: 216-721-4010
  • Fax: 216-721-5517
Mailing address:
  • Phone: 216-325-9270
  • Fax: 216-721-5517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPMY.022800200-03
License Number StateOH

VIII. Authorized Official

Name: DANIEL FRECH
Title or Position: RCM
Credential:
Phone: 216-373-2846