Basic Information
Provider Information
NPI: 1669562864
EntityType: 2
ReplacementNPI:  
OrganizationName: UH REGIONAL HOSPITALS
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: UNIVERSITY HOSPITALS RICHMOND MEDICAL CENTER
OtherOrganizationType: 4
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3605 WARRENSVILLE CENTER RD
Address2: MAILSTOP MSC 9150
City: SHAKER HEIGHTS
State: OH
PostalCode: 441225203
CountryCode: US
TelephoneNumber: 2167678793
FaxNumber: 2167678778
Practice Location
Address1: 13207 RAVENNA RD
Address2:  
City: CHARDON
State: OH
PostalCode: 440247032
CountryCode: US
TelephoneNumber: 4402856000
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/16/2006
LastUpdateDate: 06/23/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: VEHOVEC
AuthorizedOfficialFirstName: MICHAEL
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: VP & CORPORATE CONTROLLER
AuthorizedOfficialTelephone: 2167678729
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/23/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
282N00000X  Y HospitalsGeneral Acute Care Hospital 

ID Information
IDTypeStateIssuerDescription
734419005OH MEDICAID


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