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MARYMOUNT PRIMARY CARE SERVICES INC NPI 1023089653


NPI Information

NPI: 1023089653
Provider Name: MARYMOUNT PRIMARY CARE SERVICES, INC
Classification: Preventive Medicine - 2083X0100X
Entity Type: Organization

Specialization: Occupational Medicine

Address:
17747 CHILLICOTHE RD
SUITE 100
CHAGRIN FALLS, OH
ZIP 44023
Phone: (440) 543-8855
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MARYMOUNT PRIMARY CARE SERVICES, INC is an occupational medicine preventive medicine in Chagrin Falls, OH. The provider is occupational medicine focuses on the health of workers, including the ability to perform work; the physical, chemical, biological, and social environments of the workplace; and the health outcomes of environmental exposures. Practitioners in this field address the promotion of health in the work place, and the prevention and management of occupational and environmental injury, illness, and disability. MARYMOUNT PRIMARY CARE SERVICES, INC NPI is 1023089653. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

17747 CHILLICOTHE RD
SUITE 100
CHAGRIN FALLS, OH
ZIP 44023-739
Phone: (440) 543-8855
Fax: (440) 543-2470

The provider's authorized official is Peter P Walchanowicz .
The authorized official title is Practice Manager and has the following contact phone number (440) 543-8855.

The enumeration date for this NPI number is 1/31/2006 and was last updated on 7/28/2008.


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:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12084N0400XPsychiatry & NeurologyNeurologyNo
2332B00000XDurable Medical Equipment & Medical SuppliesNo
3207Q00000XFamily MedicineNo
4207R00000XInternal MedicineNo
52083X0100XPreventive MedicineOccupational MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10139719MEDICAIDOHIO
21280450001MEDICARE NSCOHIO
3CK0694MEDICARE PINOHIO
4000000028432OTHEROHIOANTHEM
59265461MEDICARE PINOHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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