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General NPI Number Information
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NPI Number | 1811328594
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Entity Type | Organization
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Legal Business Name | POEL, INC.
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Dates
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Enumeration Date | 12/06/2013
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Last Update Date | 12/06/2013
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Provider Practice Location Address
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Address Line | 1120 POLARIS PKWY
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City | COLUMBUS
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State | OH
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Zip | 43240-4042
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Country | US
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Telephone | 440-274-5000
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Fax | 440-716-8608
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Provider Business Mailing Address
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Address Line | 30701 LORAIN RD STE A
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City | NORTH OLMSTED
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State | OH
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Zip | 44070-6325
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Country | US
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Telephone | 440-274-5000
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Fax | 440-716-8608
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROGER GARCIA
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Credential | D.O.
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Telephone | 440-274-5000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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License Number | 34003736
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License Number State | OH
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