MEDICARE: CITY OF SHAKER HEIGHTS CITY HALL

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	251K00000X	Public Health or Welfare Agency	35.048282	OH

General Provider Information

NPI Number	:	1780801878
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF SHAKER HEIGHTS CITY HALL

Provider Business Mailing Address
First Line	:	3400 LEE RD
Second Line	:
City	:	SHAKER HEIGHTS
State	:	OH
Zip	:	44120-3408
Country	:	US
Telephone Number	:	216-491-1480
Fax Number	:	216-491-1439

Provider Business Practice Location Address
First Line	:	3400 LEE RD
Second Line	:
City	:	SHAKER HEIGHTS
State	:	OH
Zip	:	44120-3408
Country	:	US
Telephone Number	:	216-491-1480
Fax Number	:	216-491-1439

Authorized Official
Title or Position	:	HEALTH DIRECTOR
Name	:	DR. SCOTT HOWARD FRANK
Credential	:	M.D., M.S.
Telephone Number	:	216-491-1480

Provider Enumeration Date	:	04/19/2007
Last Update Date	:	07/16/2010

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