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General NPI Number Information
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NPI Number | 1740365071
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Entity Type | Organization
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Legal Business Name | ELGINIA CORPORATION
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1884 WYMORE
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City | EAST CLEVELAND
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State | OH
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Zip | 44112
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Country | US
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Telephone | 216-496-6253
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Fax |
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Provider Business Mailing Address
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Address Line | 1884 WYMORE
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City | EAST CLEVELAND
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State | OH
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Zip | 44112
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Country | US
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Telephone | 216-496-6253
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Fax |
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Authorized Official
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Title or Position | PRESIDENT OWNER
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Name | MS. ELGINIA PHILLIPS
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Credential | LPN
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Telephone | 216-496-6253
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 091062
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License Number State | OH
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