| Admiral Medical Management Group Llc | |
|
11201 Shaker Blvd Unit 201 Cleveland OH 44104-3869 | |
| (216) 855-7775 | |
| Not Available |
| Full Name | Admiral Medical Management Group Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 11201 Shaker Blvd Unit 201, Cleveland, Ohio |
| Authorized Official Name and Position | Ketura Jackson (APRN CNP) |
| Authorized Official Contact | 2168557775 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Admiral Medical Management Group Llc 11201 Shaker Blvd Unit 201 Cleveland OH 44104-3869 Ph: (216) 855-7775 | Admiral Medical Management Group Llc 11201 Shaker Blvd Unit 201 Cleveland OH 44104-3869 Ph: (216) 855-7775 |
| NPI Number | 1407357742 |
|---|---|
| Provider Enumeration Date | 02/22/2018 |
| Last Update Date | 09/17/2024 |
| Medicare PECOS PAC ID | 9638415987 |
|---|---|
| Medicare Enrollment ID | O20190108002744 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407357742 | NPI | - | NPPES |
| Provider Name | Ketura Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821229378 PECOS PAC ID: 0648555698 Enrollment ID: I20170314001604 |
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