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General NPI Number Information
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NPI Number | 1770813099
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Entity Type | Organization
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Legal Business Name | RAE-ANN GENEVA
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Dates
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Enumeration Date | 01/08/2010
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Last Update Date | 01/08/2010
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Provider Practice Location Address
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Address Line | 839 W MAIN ST
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City | GENEVA
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State | OH
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Zip | 44041-1218
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Country | US
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Telephone | 440-466-5733
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Fax |
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Provider Business Mailing Address
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Address Line | 839 W MAIN ST
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City | GENEVA
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State | OH
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Zip | 44041-1218
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN GRIFFITHS
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Credential |
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Telephone | 440-835-3005
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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 |
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License Number State |
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