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NPI Code Detail

MEDICARE: SISTERS OF ST. JOSEPH OF ST. MARK - MOUNT ST. JOSEPH

MEDICARE: SISTERS OF ST. JOSEPH OF ST. MARK - MOUNT ST. JOSEPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility206OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1365487OTHERMEDICARE PROVIDER NUMBER

General Provider Information

NPI Number : 1053309211
Entity Type Code : Organization
Provider Name (Legal Business Name) : SISTERS OF ST. JOSEPH OF ST. MARK - MOUNT ST. JOSEPH
Provider Business Mailing Address
First Line : 21800 CHARDON RD
Second Line :
City : EUCLID
State : OH
Zip : 44117-2125
Country : US
Telephone Number : 216-531-7426
Fax Number : 216-531-4033
Provider Business Practice Location Address
First Line : 21800 CHARDON RD
Second Line :
City : EUCLID
State : OH
Zip : 44117-2125
Country : US
Telephone Number : 216-531-7426
Fax Number : 216-531-4033
Authorized Official
Title or Position : ADMINISTRATOR
Name : SISTER MARY RAPHAEL GREGG
Credential : RN., LNHA
Telephone Number : 216-531-7426
Provider Enumeration Date : 10/12/2005
Last Update Date : 09/09/2014

Similar Medicare Providers

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1821247362 — MRS. MICHELLE GENOVESE
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1558512574 — ELISABETH KLINE
Practice Location Address:
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EUCLID, OH
44117-2125
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Practice Fax:
1396996310 — GLADYS MICHELLE COCHRAN
Practice Location Address:
21800 CHARDON RD
EUCLID, OH
44117-2125
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Practice Fax:
1669079661 — MRS. RACHELLE GEISINGER
Practice Location Address:
21800 CHARDON RD
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Practice Phone: 216-531-7426
Practice Fax: 216-531-7911

Directions to “SISTERS OF ST. JOSEPH OF ST. MARK - MOUNT ST. JOSEPH ” Practice Location

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