Healthcare Provider Details

I. General information

NPI: 1629422480
Provider Name (Legal Business Name): EMH REGIONAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2016
Last Update Date: 04/29/2024
Certification Date: 04/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 E RIVER ST
ELYRIA OH
44035-5902
US

IV. Provider business mailing address

PO BOX 772930
DETROIT MI
48277-2930
US

V. Phone/Fax

Practice location:
  • Phone: 440-329-7500
  • Fax:
Mailing address:
  • Phone: 440-329-7500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: ANTHONY SCHILLERO
Title or Position: DIRECTOR, FP&A
Credential:
Phone: 216-767-8141