| Marymount Primary Care Services, Inc | |
|
4400 Rockside Rd Suite 2100 Independence OH 44131-2109 | |
| (216) 573-1300 | |
| (216) 503-5005 |
| Full Name | Marymount Primary Care Services, Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4400 Rockside Rd, Independence, Ohio |
| Authorized Official Name and Position | Peter P Walchanowicz (PRACTICE MANAGER) |
| Authorized Official Contact | 4405438855 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Marymount Primary Care Services, Inc 4400 Rockside Rd Suite 2100 Independence OH 44131-2109 Ph: (216) 573-1300 | Marymount Primary Care Services, Inc 4400 Rockside Rd Suite 2100 Independence OH 44131-2109 Ph: (216) 573-1300 |
| NPI Number | 1326265000 |
|---|---|
| Provider Enumeration Date | 04/20/2007 |
| Last Update Date | 05/27/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326265000 | NPI | - | NPPES |
| 2698559 | Medicaid | OH | |
| 000000564073 | Other | OH | ANTHEM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Secondary |
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