| Marymount Primary Care Services, Inc. | |
|
6701 Rockside Rd Suite 260 Independence OH 44131-2358 | |
| (216) 369-2525 | |
| (216) 369-2531 |
| Full Name | Marymount Primary Care Services, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 6701 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. 6701 Rockside Rd Suite 260 Independence OH 44131-2358 Ph: (216) 369-2525 | Marymount Primary Care Services, Inc. 6701 Rockside Rd Suite 260 Independence OH 44131-2358 Ph: (216) 369-2525 |
| NPI Number | 1902097751 |
|---|---|
| Provider Enumeration Date | 08/07/2007 |
| Last Update Date | 05/28/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902097751 | NPI | - | NPPES |
| 000000564009 | Other | OH | ANTHEM |
| 2686106 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 363AM0700X | Physician Assistant - Medical | (* (Not Available)) | Secondary |
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Marymount Primary Care Services, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4400 Rockside Rd, Suite 2100, Independence, OH 44131 Phone: 216-573-1300 Fax: 216-503-5005 | |
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