ST JUDES MEDICAL CLINIC; NPI #1609884592

Contact Information

ST JUDES MEDICAL CLINIC

7211 BROADWAY
CLEVELAND, OH 44105

Phone: 216-271-1947
Fax: 216-271-0106
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	General Practice	208D00000X	99	Physician/Undefined Physician type[6]

Indicates primary specialty

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NPI Profile & details for ST JUDES MEDICAL CLINIC

NPI Number 1609884592

LBN Legal business name ST JUDES MEDICAL CLINIC

Authorized official NELIDA ENRIQUE - (PRESIDENT TREASURER)

Entity Organization

Organization subpart ¹ No

Enumeration date 08/04/2006

Last updated 02/22/2010 - About 16 years ago

Identifiers

OH	License #	35033404
OH	Medicaid	0325866

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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ST JUDES MEDICAL CLINIC

Contact Information

Specialty

General Practice

NPI Profile & details for ST JUDES MEDICAL CLINIC

Reviews for ST JUDES MEDICAL CLINIC