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Contact Information

OUTREACH PROFESSIONAL SERVICES INC
2322 EAST 22ND ST
SUITE 200
CLEVELAND, OH44115
 Phone: 216-658-8410
 Fax: 216-363-3323
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Medical Oncology

207RX0202X 11 Physician/Internal Medicine
 

Thoracic Surgery (Cardiothoracic Vascular Surgery)

208G00000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for OUTREACH PROFESSIONAL SERVICES INC

NPI Number 1780866392
LBN Legal business name OUTREACH PROFESSIONAL SERVICES INC
Authorized official MISTY BLAYLOCK - (CREDENTIALING COORDINATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 12/05/2007
Last updated 01/12/2010 - About 16 years ago
Identifiers
OH Medicaid 0251856
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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