Marymount Primary Care Services, Inc | |
4400 Rockside Rd Suite 2100 Independence OH 44131-2109 | |
(216) 573-1300 | |
(216) 503-5005 |
Full Name | Marymount Primary Care Services, Inc |
---|---|
Speciality | Internal Medicine |
Location | 4400 Rockside Rd, Independence, Ohio |
Authorized Official Name and Position | Peter P Walchanowicz (PRACTICE MANAGER) |
Authorized Official Contact | 4405438855 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Marymount Primary Care Services, Inc 4400 Rockside Rd Suite 2100 Independence OH 44131-2109 Ph: (216) 573-1300 | Marymount Primary Care Services, Inc 4400 Rockside Rd Suite 2100 Independence OH 44131-2109 Ph: (216) 573-1300 |
NPI Number | 1326265000 |
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Provider Enumeration Date | 04/20/2007 |
Last Update Date | 05/27/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1326265000 | NPI | - | NPPES |
2698559 | Medicaid | OH | |
000000564073 | Other | OH | ANTHEM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Secondary |
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