Abco Medical Center, L.L.C.
Organization Active NPI Family Medicine Physician · Lakewood, OH
NPI 1023384591 · NPPES record last updated Mar 28, 2012
Key facts
- NPI
- 1023384591
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 34-003811 (OH)
- Legal business name
- ABCO MEDICAL CENTER, L.L.C.
- Practice address
- 13535 Detroit Ave Ste 4
Lakewood, OH 44107-4625 - Phone
- (216) 226-2626
- Fax
- (216) 226-6745
- NPI assigned
- Mar 28, 2012
- Organization subpart
- No
Authorized official
- Name
- Dr. Abdul M. Orra, D.O.
- Title
- Owner
- Phone
- (216) 226-2626
Practitioners 2
-
Abdul M Orra, DO
-
Nura Orra, D.O.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 36D0874578 | Abco Medical Center, LLC | Certificate of waiver | Sep 26, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120502000464 | OH | Part B Supplier - Clinic/Group Practice | 2567624828 |
Receives reassigned benefits from 1 practitioner Practice locations: Lakewood, OH |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | 34-003811 | OH | Yes |
Addresses
Primary practice location
13535 Detroit Ave Ste 4
Lakewood, OH 44107-4625
Mailing address
PO Box 357
North Olmsted, OH 44070-0357
Phone (216) 226-2626
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0582570 | Medicaid | OH |
Other providers in Lakewood, OH
- Nicholas Joseph Abdallah
- Ashley Abdul-Karim
- Abilies Resource, Inc.
- Yoseph Abukhalil
- Achieve Chiropractic LLC
All providers in Lakewood, OH · Family Medicine Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 28, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.