Basic Information
| Provider Information | |||||||||
| NPI: | 1548405665 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CV MEDICAL SERVICES, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3755 ORANGE PL STE 105 | ||||||||
| Address2: | |||||||||
| City: | BEACHWOOD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441224426 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2167650358 | ||||||||
| FaxNumber: | 2167650378 | ||||||||
| Practice Location | |||||||||
| Address1: | 3755 ORANGE PL STE 105 | ||||||||
| Address2: | |||||||||
| City: | BEACHWOOD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2167650358 | ||||||||
| FaxNumber: | 2167650378 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/03/2008 | ||||||||
| LastUpdateDate: | 09/19/2019 | ||||||||
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| AuthorizedOfficialLastName: | HARRIS | ||||||||
| AuthorizedOfficialFirstName: | DEBBIE | ||||||||
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| AuthorizedOfficialTitleorPosition: | COO | ||||||||
| AuthorizedOfficialTelephone: | 2167650358 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261Q00000X | N | Ambulatory Health Care Facilities | Clinic/Center | 363AM0700X | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.