MEDICARE: PRETERM CLEVELAND INC

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	261QA1903X	Ambulatory Surgical Clinic/Center	0288AS	OH

Other Identifiers

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

General Provider Information

NPI Number	:	1326048182
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRETERM CLEVELAND INC

Provider Business Mailing Address
First Line	:	12000 SHAKER BLVD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44120-1922
Country	:	US
Telephone Number	:	216-991-4577
Fax Number	:	216-991-4571

Provider Business Practice Location Address
First Line	:	12000 SHAKER BLVD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44120-1922
Country	:	US
Telephone Number	:	216-991-4577
Fax Number	:	216-991-4571

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MS. CHRISSE FRANCE
Credential	:
Telephone Number	:	216-991-4577

Provider Enumeration Date	:	07/22/2005
Last Update Date	:	08/22/2020

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Directions to “PRETERM CLEVELAND INC ” Practice Location

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