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NPI Code Detail

MEDICARE: NORTH COAST PROFESSIONAL COMPANY, LLC

MEDICARE: NORTH COAST PROFESSIONAL COMPANY, LLC
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
1163W00000XRegistered Nurse
2207Q00000XFamily Medicine Physician
3207RC0200XCritical Care Medicine (Internal Medicine) Physician
4207RI0200XInfectious Disease Physician
5207RN0300XNephrology Physician
6207RP1001XPulmonary Disease Physician
7207RS0012XSleep Medicine (Internal Medicine) Physician
8207V00000XObstetrics & Gynecology Physician
9208000000XPediatrics Physician
10208200000XPlastic Surgery Physician
112083X0100XOccupational Medicine Physician
12225400000XRehabilitation Practitioner
13363L00000XNurse Practitioner
14364S00000XClinical Nurse Specialist
15207R00000XInternal Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1881648210
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTH COAST PROFESSIONAL COMPANY, LLC
Provider Business Mailing Address
First Line : 1912 HAYES AVE STE 1E
Second Line :
City : SANDUSKY
State : OH
Zip : 44870-4736
Country : US
Telephone Number : 419-557-5541
Fax Number : 419-557-5542
Provider Business Practice Location Address
First Line : 1912 HAYES AVE STE 1E
Second Line :
City : SANDUSKY
State : OH
Zip : 44870-4736
Country : US
Telephone Number : 419-557-5541
Fax Number : 419-557-5542
Authorized Official
Title or Position : EXECUTIVE VICE PRESIDENT
Name : ROBERT MOORE
Credential :
Telephone Number : 419-557-5541
Provider Enumeration Date : 05/20/2006
Last Update Date : 08/24/2022

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44870-4736
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1689625295 — CHRISTOPHER PARNELL D.O.
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Practice Phone: 419-557-6780
Practice Fax: 419-557-6783
1124066105 — CLEVELAND VAMC
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1710926985 — DR. MICHAEL S BLANK MD
Practice Location Address:
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44870-4736
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Directions to “NORTH COAST PROFESSIONAL COMPANY, LLC ” Practice Location

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