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NPI Code Detail

MEDICARE: MARYMOUNT HOSPITAL INC

MEDICARE: MARYMOUNT HOSPITAL 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
1208D00000XGeneral Practice Physician

General Provider Information

NPI Number : 1730011123
Entity Type Code : Organization
Provider Name (Legal Business Name) : MARYMOUNT HOSPITAL INC
Provider Business Mailing Address
First Line : 6801 BRECKSVILLE RD STE 20
Second Line : ATTN DPC RK 2-7
City : INDEPENDENCE
State : OH
Zip : 44131-5062
Country : US
Telephone Number : 999-999-9999
Fax Number :
Provider Business Practice Location Address
First Line : 5555 TRANSPORTATION BLVD
Second Line : 2ND FLOOR
City : GARFIELD HEIGHTS
State : OH
Zip : 44125-5371
Country : US
Telephone Number : 216-444-2273
Fax Number :
Authorized Official
Title or Position : EXECUTIVE VP CHIEF FINANCE OFFICER
Name : DENNIS LEE LARAWAY
Credential :
Telephone Number : 216-445-1343
Provider Enumeration Date : 06/01/2026
Last Update Date : 06/01/2026

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Directions to “MARYMOUNT HOSPITAL INC ” Practice Location

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