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General NPI Number Information
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NPI Number | 1710206917
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Entity Type | Organization
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Legal Business Name | NORTHCOAST HEALTH CARE MANAGEMENT SERVICES
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Dates
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Enumeration Date | 05/27/2010
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Last Update Date | 12/01/2021
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Provider Practice Location Address
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Address Line | 4199 KINROSS LAKES PKWY STE 220
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City | RICHFIELD
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State | OH
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Zip | 44286-9394
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Country | US
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Telephone | 440-212-8828
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Fax |
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Provider Business Mailing Address
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Address Line | 4199 KINROSS LAKES PKWY STE 220
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City | RICHFIELD
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State | OH
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Zip | 44286-9394
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Country | US
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Telephone | 440-212-8828
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Fax |
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Authorized Official
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Title or Position | EVP BUSINESS DEVELOPMENT
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Name | AMY MARIE KONOPKA
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Credential |
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Telephone | 216-591-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number |
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License Number State |
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