Middleburg-Legacy Place, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

36D0991700 Issued in OH

Legal business name

MIDDLEBURG-LEGACY PLACE, LLC

Doing business as

Parkside Villa - Laboratory

Practice address

7040 Hepburn Rd
Middleburg Heights, OH 44130-4802

Phone

(440) 260-7626

NPI assigned

Aug 5, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Bruce Daskal

Title

Owner

Phone

(440) 260-7626

Specialties & licenses 1

Addresses

Other names 1

• Parkside Villa - Laboratory Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Middleburg-Legacy Place LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Middleburg-Legacy Place, LLC

  dba Parkside Villa

  • Assisted Living Facility
  • Middleburg Heights, OH
  • NPI 1396544342
  NPD tax ID
• Middleburg-Legacy Place, LLC

  dba Parkside Villa

  • Skilled Nursing Facility
  • Cleveland, OH
  • NPI 1619078938
  NPD tax ID

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

{
    "created_epoch": "1217894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217894400000",
    "number": "1184880577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7040 HEPBURN RD",
            "city": "MIDDLEBURG HEIGHTS",
            "state": "OH",
            "postal_code": "441304802",
            "telephone_number": "440-260-7626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7040 HEPBURN RD",
            "city": "MIDDLEBURG HEIGHTS",
            "state": "OH",
            "postal_code": "441304802",
            "telephone_number": "440-260-7626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDLEBURG-LEGACY PLACE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-05",
        "last_updated": "2008-08-05",
        "status": "A",
        "authorized_official_last_name": "DASKAL",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "440-260-7626",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "OH",
            "license": "36D0991700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Parkside Villa - Laboratory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Middleburg Heights Alf Operations
• Middleburg Heights Dentistry (Psota Family Dentistry)
• Middleburg Heights Magic Dentistry LLC - Michael Crites DDS (Magic Dentistry)
• Middleburg Heights Podiatry LTD
• Middleburg Heights Podiatry LTD
• Middleburg-Legacy Place, LLC (Parkside Villa)
• Adam Joseph Miller
• Erica Miller
• Sam Miller
• Shelly Kay Mills, MD

• Clinical Medical Laboratory in Middleburg Heights, OH
• Providers in Middleburg Heights, OH by specialty
• Clinical Medical Laboratory in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.