Healthcare Provider Details

I. General information

NPI: 1184768616
Provider Name (Legal Business Name): AUGUST HEALTH SERVICES INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2007
Last Update Date: 02/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4850 HICKORY NUT LN
INDEPENDENCE OH
44131-4640
US

IV. Provider business mailing address

12744 STATE ROAD
NORTH ROYALTON OH
44133
US

V. Phone/Fax

Practice location:
  • Phone: 216-524-2521
  • Fax: 216-524-2521
Mailing address:
  • Phone: 440-582-1484
  • Fax: 440-582-1321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. DONNA L. LANZA
Title or Position: VICE PRESIDENT-MEDICAL OPERATIONS
Credential: CNP
Phone: 440-582-1484