NPIMap

Organization Active NPI

Dedicated Ohio Holding, LLC

Doing business as Dedicated Senior Medical Center Collinwood

  • Non-Pharmacy Dispensing Site
  • Cleveland, OH
National Provider Identifier
1023641867
Registry record updated Jun 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
DEDICATED OHIO HOLDING, LLC
Doing business as
Dedicated Senior Medical Center Collinwood
Dedicated Senior Medical Center East Cleveland
Practice address
15105 Saint Clair Ave
Cleveland, OH 44110-3719
Phone
(216) 800-8020
NPI assigned
Feb 20, 2020
Last updated
Jun 16, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
DEDICATED OHIO HOLDING, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 16, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mary Chen
Title
Owner
Phone
(305) 628-6117

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X NU Primary

Addresses

Primary practice location

15105 Saint Clair Ave
Cleveland, OH 44110-3719

Mailing address

1395 NW 167TH St
Miami, FL 33169-5710

Other names 2

  • Dedicated Senior Medical Center Collinwood Doing business as
  • Dedicated Senior Medical Center East Cleveland Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dedicated Ohio Holding LLC6 organizations share this tax ID, including this one
Part of
Dedicated Ohio Holding LLC

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1582156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592265600000",
    "number": "1023641867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 NW 167TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331695710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15105 SAINT CLAIR AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441103719",
            "telephone_number": "216-800-8020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEDICATED OHIO HOLDING, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DEDICATED OHIO HOLDING, LLC",
        "enumeration_date": "2020-02-20",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-628-6117"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dedicated Senior Medical Center Collinwood",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dedicated Senior Medical Center East Cleveland",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.