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General NPI Number Information
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NPI Number | 1083323687
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Entity Type | Organization
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Legal Business Name | ST VINCENT CHARITY MEDICAL CENTER
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Dates
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Enumeration Date | 11/22/2022
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 2475 E 22ND ST STE 120
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City | CLEVELAND
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State | OH
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Zip | 44115-3221
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Country | US
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Telephone | 216-431-1500
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Fax | 216-431-7701
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Provider Business Mailing Address
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Address Line | PO BOX 932004
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City | CLEVELAND
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State | OH
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Zip | 44193-0007
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Country | US
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Telephone | 216-363-2570
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Fax |
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Authorized Official
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Title or Position | FINANCE DIRECTOR
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Name | THERESA WRABEL
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Credential |
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Telephone | 216-363-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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