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General NPI Number Information
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NPI Number | 1699307462
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Entity Type | Organization
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Legal Business Name | PREMIER RHEUMATOLOGY GROUP AND INFUSION LLC
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Dates
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Enumeration Date | 02/10/2020
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Last Update Date | 09/12/2025
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Provider Practice Location Address
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Address Line | 18660 BAGLEY RD STE 102B
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City | CLEVELAND
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State | OH
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Zip | 44130-3483
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Country | US
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Telephone | 440-891-2413
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Fax |
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Provider Business Mailing Address
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Address Line | 18660 BAGLEY RD STE 102B
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City | CLEVELAND
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State | OH
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Zip | 44130-3483
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Country | US
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Telephone |
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Fax | 440-673-1926
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Authorized Official
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Title or Position | AO
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Name | CHERISH HOPE COGAR
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Credential | CMA
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Telephone | 216-466-7955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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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 | 207RR0500X
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Taxonomy Name | Rheumatology 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 | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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