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NPI Code Detail

MEDICARE: RAE-ANN INC.

MEDICARE: RAE-ANN 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
1291U00000XClinical Medical Laboratory

General Provider Information

NPI Number : 1952631277
Entity Type Code : Organization
Provider Name (Legal Business Name) : RAE-ANN INC.
Provider Business Mailing Address
First Line : 4650 ROCKY RIVER DR
Second Line :
City : CLEVELAND
State : OH
Zip : 44135-3846
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4650 ROCKY RIVER DR
Second Line :
City : CLEVELAND
State : OH
Zip : 44135-3846
Country : US
Telephone Number : 216-267-5445
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : JOHN GRIFFITHS
Credential :
Telephone Number : 440-835-3005
Provider Enumeration Date : 01/08/2010
Last Update Date : 01/08/2010

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