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General NPI Number Information
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NPI Number | 1982081360
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Entity Type | Organization
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Legal Business Name | PRIMARY CARE HEALTHWORKS LLC
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Dates
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Enumeration Date | 05/05/2015
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Last Update Date | 05/20/2015
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Provider Practice Location Address
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Address Line | 2000 AUBURN DR SUITE 200
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City | BEACHWOOD
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State | OH
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Zip | 44122-4314
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Country | US
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Telephone | 440-934-6135
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Fax | 440-934-6147
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Provider Business Mailing Address
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Address Line | 2000 AUBURN DR SUITE 200
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City | BEACHWOOD
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State | OH
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Zip | 44122-4314
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Country | US
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Telephone | 440-934-6135
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Fax | 440-934-6147
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | SUE IRWIN
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Credential |
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Telephone | 440-934-6135
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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