Healthcare Provider Details
I. General information
NPI: 1497805766
Provider Name (Legal Business Name): COMMUNITY HOSPITALIST, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/11/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
29000 CENTER RIDGE RD
WESTLAKE OH
44145-5293
US
IV. Provider business mailing address
30680 BAINBRIDGE RD
SOLON OH
44139-2282
US
V. Phone/Fax
- Phone: 440-835-8000
- Fax:
- Phone: 440-542-5023
- Fax: 440-542-5029
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHRISTINE
L
MORRISON
Title or Position: VICE PRESIDENT
Credential:
Phone: 440-542-5000