MEDICARE: ROBERT B. HOOPINGARNER P.C.C.

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
1	1041C0700X	Clinical Social Worker	E1400007	OH

General Provider Information

NPI Number	:	1184041790
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT B. HOOPINGARNER P.C.C.

Provider Business Mailing Address
First Line	:	25101 CHAGRIN BLVD
Second Line	:	SUITE 100
City	:	BEACHWOOD
State	:	OH
Zip	:	44122-5643
Country	:	US
Telephone Number	:	216-831-6611
Fax Number	:	216-456-8128

Provider Business Practice Location Address
First Line	:	25101 CHAGRIN BLVD
Second Line	:	SUITE 100
City	:	BEACHWOOD
State	:	OH
Zip	:	44122-5643
Country	:	US
Telephone Number	:	216-831-6611
Fax Number	:	216-456-8128

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2014
Last Update Date	:	04/04/2014

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