Healthcare Provider Details

I. General information

NPI: 1619077989
Provider Name (Legal Business Name): ENT & ALLERGY HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 06/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 KOLBE RD SUITE #227
LORAIN OH
44053-1654
US

IV. Provider business mailing address

25761 LORAIN RD 3RD FL
NORTH OLMSTED OH
44070-3327
US

V. Phone/Fax

Practice location:
  • Phone: 440-282-5910
  • Fax:
Mailing address:
  • Phone: 440-779-1112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY EDWARD BINDER
Title or Position: PRESIDENT
Credential: D.O.
Phone: 440-779-1112