DEDICATED OHIO HOLDING LLC NPI 1295368397

NPI Information

DEDICATED OHIO HOLDING LLC is a non pharmacy dispensing site in Cleveland, OH. The provider is a site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) DEDICATED OHIO HOLDING LLC NPI is 1295368397. The provider is registered as an organization entity type.
The provider Is Doing Business As Dedicated Senior Medical Center West Park.

The provider's business location address is:

13719 LORAIN AVE
CLEVELAND, OH
ZIP 44111-439
Phone: (216) 307-3005

The provider's authorized official is Mary Chen .
The authorized official title is Owner and has the following contact phone number (305) 628-6117.

The CLIA number assigned to this NPI record is 36D2188018 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/17/2020 and was last updated on 4/23/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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