CLEVELAND AVENUE PROFESSIONAL CENTER; NPI #1922193010

Contact Information

CLEVELAND AVENUE PROFESSIONAL CENTER

5910 CLEVELAND AVE
COLUMBUS, OH 43231-6881

Phone: 614-882-4343
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Ambulatory Surgical	261QA1903X	49	Ambulatory Surgical Center

Indicates primary specialty

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NPI Profile & details for CLEVELAND AVENUE PROFESSIONAL CENTER

NPI # 1922193010

LBN Legal business name CLEVELAND AVENUE PROFESSIONAL CENTER

Authorized official MILROY SAMUEL - (OWNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 10/04/2006

Last updated 03/17/2008 - About 18 years ago

Identifiers

OH	License #	35075146-S
OH	Medicaid	2465738

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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