| Northeast Ohio Neighborhood Health Services, Inc. | |
|
10505 Saint Clair Ave Ste 101 Cleveland OH 44108-1973 | |
| (216) 325-6556 | |
| (216) 231-3828 |
| Full Name | Northeast Ohio Neighborhood Health Services, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 10505 Saint Clair Ave Ste 101, Cleveland, Ohio |
| Authorized Official Name and Position | Vicki Marie (PROVIDER RELATIONS MANAGER) |
| Authorized Official Contact | 2162317700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northeast Ohio Neighborhood Health Services, Inc. 4800 Payne Ave Cleveland OH 44103-2443 Ph: (216) 231-7700 | Northeast Ohio Neighborhood Health Services, Inc. 10505 Saint Clair Ave Ste 101 Cleveland OH 44108-1973 Ph: (216) 325-6556 |
| NPI Number | 1578055174 |
|---|---|
| Provider Enumeration Date | 05/31/2018 |
| Last Update Date | 02/20/2019 |
| Medicare PECOS PAC ID | 5799756615 |
|---|---|
| Medicare Enrollment ID | O20190131002199 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578055174 | NPI | - | NPPES |
| 0333579 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Pamela Graham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437651445 PECOS PAC ID: 0840542098 Enrollment ID: I20181016002823 |
| Provider Name | Pamela S Pope |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285261503 PECOS PAC ID: 8224446026 Enrollment ID: I20210415002040 |
| Provider Name | Nurat Adigun |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376122523 PECOS PAC ID: 5890193361 Enrollment ID: I20211013003422 |
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