Westshore Primary Care Assoc Inc | |
5323 Meadow Lane Elyria OH 44035 | |
(440) 934-0276 | |
(440) 934-0272 |
Full Name | Westshore Primary Care Assoc Inc |
---|---|
Speciality | Family Medicine |
Location | 5323 Meadow Lane, Elyria, Ohio |
Authorized Official Name and Position | Misty A Blaylock (CREDENTIALING COORDINATOR) |
Authorized Official Contact | 4408926406 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Westshore Primary Care Assoc Inc 26908 Detroit Rd Suite 301 Westlake OH 44145-2398 Ph: (440) 617-1823 | Westshore Primary Care Assoc Inc 5323 Meadow Lane Elyria OH 44035 Ph: (440) 934-0276 |
NPI Number | 1609983600 |
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Provider Enumeration Date | 08/24/2006 |
Last Update Date | 01/12/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1609983600 | NPI | - | NPPES |
0858077 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
208000000X | Pediatrics | (* (Not Available)) | Secondary |
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