Healthcare Provider Details

I. General information

NPI: 1114273943
Provider Name (Legal Business Name): REMEDI SENIORCARE OF OHIO-NORTHEAST LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2012
Last Update Date: 04/15/2025
Certification Date: 04/10/2025
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 Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License NumberPSNH022237750
License Number StateOH

VIII. Authorized Official

Name: MR. ALAN BRONFEIN
Title or Position: SVP
Credential:
Phone: 443-927-8403