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General NPI Number Information
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NPI Number | 1578726733
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Entity Type | Organization
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Legal Business Name | EAST PARK CARE CENTER
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Dates
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Enumeration Date | 07/08/2008
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Last Update Date | 07/08/2008
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Provider Practice Location Address
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Address Line | 8 E PARK CIR
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City | BROOK PARK
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State | OH
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Zip | 44142-3800
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Country | US
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Telephone | 216-267-7229
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Fax |
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Provider Business Mailing Address
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Address Line | 8 E PARK CIR
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City | BROOK PARK
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State | OH
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Zip | 44142-3800
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Country | US
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Telephone | 216-267-7229
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Fax |
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Authorized Official
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Title or Position | CONTROLLER
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Name | BOB NEMETZ
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Credential |
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Telephone | 440-250-4080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 36D0339113
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License Number State | OH
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