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NPI Code Detail

MEDICARE: CRU CLINIC

MEDICARE: CRU CLINIC
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
1261Q00000XClinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215526934
Entity Type Code : Organization
Provider Name (Legal Business Name) : CRU CLINIC
Provider Business Mailing Address
First Line : 2293 VILLAGE PARK CT
Second Line :
City : ONTARIO
State : OH
Zip : 44906-1167
Country : US
Telephone Number : 419-775-5457
Fax Number : 866-500-5148
Provider Business Practice Location Address
First Line : 2293 VILLAGE PARK CT
Second Line :
City : ONTARIO
State : OH
Zip : 44906-1167
Country : US
Telephone Number : 419-775-5457
Fax Number : 866-500-5148
Authorized Official
Title or Position : NURSE PRACTITIONER
Name : MRS. JENNY SWISHER
Credential : CNP
Telephone Number : 419-989-3180
Provider Enumeration Date : 01/17/2021
Last Update Date : 02/20/2023

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Directions to “CRU CLINIC ” Practice Location

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