Healthcare Provider Details

I. General information

NPI: 1164577904
Provider Name (Legal Business Name): COUNTY OF CUYAHOGA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 03/28/2023
Certification Date: 03/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5550 VENTURE DR
PARMA OH
44130-9315
US

IV. Provider business mailing address

5550 VENTURE DR
PARMA OH
44130-9315
US

V. Phone/Fax

Practice location:
  • Phone: 216-201-2001
  • Fax: 216-676-1311
Mailing address:
  • Phone: 216-201-2001
  • Fax: 216-676-1311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QA0005X
TaxonomyAmbulatory Family Planning Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QF0050X
TaxonomyNon-Surgical Family Planning Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QP0905X
TaxonomyState or Local Public Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARCIEA STEWART
Title or Position: MEDICAL CREDENTIALING MGR.
Credential: CMS, CMIS, CPAT
Phone: 216-201-2001