Healthcare Provider Details

I. General information

NPI: 1841337920
Provider Name (Legal Business Name): WOODMERE VILLAGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 06/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27899 CHAGRIN BLVD.
WOODMERE VILLAGE OH
44122
US

IV. Provider business mailing address

27899 CHAGRIN BLVD.
WOODMERE VILLAGE OH
44122
US

V. Phone/Fax

Practice location:
  • Phone: 216-831-9511
  • Fax: 216-292-7023
Mailing address:
  • Phone: 216-831-9511
  • Fax: 216-292-7023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: JOHNNY BREWINGTON
Title or Position: FIRE CHIEF
Credential:
Phone: 216-292-4103