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JUBILEE HEALTHCARE LLC NPI 1093206138


NPI Information

NPI: 1093206138
Provider Name: JUBILEE HEALTHCARE, LLC

Doing Business As: NORTHSHORE HEALTHCARE

Classification: Durable Medical Equipment & Medical Supplies - 332B00000X
Entity Type: Organization

CLIA Number: 36D0903342

Address:
13170 RAVENNA RD STE 200
CHARDON, OH
ZIP 44024
Phone: (844) 542-6363
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JUBILEE HEALTHCARE, LLC is a durable medical equipment medical supplies in Chardon, OH. The provider is a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time. JUBILEE HEALTHCARE, LLC NPI is 1093206138. The provider is registered as an organization entity type.
The provider Is Doing Business As Northshore Healthcare.

The provider's business location address is:

13170 RAVENNA RD STE 200
CHARDON, OH
ZIP 44024-022
Phone: (844) 542-6363
Fax: (216) 455-1810

The provider's authorized official is Kelly A Mowrer .
The authorized official title is Credentialing and has the following contact phone number (440) 895-5056.

The CLIA number assigned to this NPI record is 36D0903342 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/24/2018 and was last updated on 6/16/2018.


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
1332B00000XDurable Medical Equipment & Medical SuppliesYes

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
10192836MEDICAIDOHIO

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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