Healthcare Provider Details

I. General information

NPI: 1235594615
Provider Name (Legal Business Name): REMEDI SENIORCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2015
Last Update Date: 12/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26251 BLUESTONE BLVD STE 1
EUCLID OH
44132-2826
US

IV. Provider business mailing address

26251 BLUESTONE BLVD STE 1
EUCLID OH
44132-2826
US

V. Phone/Fax

Practice location:
  • Phone: 216-242-0000
  • Fax: 877-953-2494
Mailing address:
  • Phone: 216-242-0000
  • Fax: 877-953-2494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number03132103
License Number StateOH

VIII. Authorized Official

Name: JACQUELYN M GRAFF
Title or Position: CLINICAL PHARMACIST
Credential: PHARMD, RPH
Phone: 216-242-0000