Healthcare Provider Details

I. General information

NPI: 1184550816
Provider Name (Legal Business Name): DENVER C BARRY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1592 LANDER RD
MAYFIELD HTS OH
44124-3320
US

IV. Provider business mailing address

1592 LANDER RD
MAYFIELD HTS OH
44124-3320
US

V. Phone/Fax

Practice location:
  • Phone: 440-449-7777
  • Fax: 800-531-7075
Mailing address:
  • Phone: 440-449-7777
  • Fax: 800-531-7075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberRP821553
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: