Healthcare Provider Details

I. General information

NPI: 1457322992
Provider Name (Legal Business Name): NORTH OHIO HEART CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2006
Last Update Date: 07/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 KOLBE RD SUITE 127
LORAIN OH
44053-1654
US

IV. Provider business mailing address

1220 MOORE RD SUITE B
AVON OH
44011-4044
US

V. Phone/Fax

Practice location:
  • Phone: 440-204-4000
  • Fax: 440-282-7579
Mailing address:
  • Phone: 440-930-4446
  • Fax: 440-934-0682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number StateOH

VIII. Authorized Official

Name: MR. GARY EDWARD THOME
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 440-930-4400