Healthcare Provider Details

I. General information

NPI: 1740098375
Provider Name (Legal Business Name): JONATHAN ROSS PARRISH JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/30/2024
Last Update Date: 12/30/2024
Certification Date: 12/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6905 BAYLISS AVE
CLEVELAND OH
44103-1515
US

IV. Provider business mailing address

6905 BAYLISS AVE
CLEVELAND OH
44103-1515
US

V. Phone/Fax

Practice location:
  • Phone: 216-744-3747
  • Fax:
Mailing address:
  • Phone: 216-744-3747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code385HR2050X
TaxonomyRespite Care Camp
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: