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University Primary Care Practices

Organization Active NPI Prosthetic/Orthotic Supplier · Euclid, OH

NPI 1306912290 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1306912290
Entity type
Organization (NPI type 2)
Primary specialty
Prosthetic/Orthotic Supplier 335E00000X
Legal business name
UNIVERSITY PRIMARY CARE PRACTICES
Practice address
18599 Lake Shore Blvd Ste 207
Euclid, OH 44119-1093
Phone
(216) 383-0100
Fax
(216) 383-6481
NPI assigned
Nov 24, 2006
Organization subpart
No

Authorized official

Name
Steve Riddle
Title
Director Billing Services
Phone
(216) 383-6480

Corporate family (same tax ID) 24

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

National Provider Directory

Tax ID family
Ge University Primary C (74 organizations share this tax ID)

Locations

18599 Lake Shore Blvd
Ste 207
Euclid, OH 44119

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X Yes

Addresses

Primary practice location

18599 Lake Shore Blvd Ste 207
Euclid, OH 44119-1093

Mailing address

PO Box 74590
Cleveland, OH 44194-0002
Phone (216) 383-6480

Other identifiers

IdentifierTypeStateIssuer
0721731MedicaidOH

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306912290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 74590",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441940002",
            "telephone_number": "216-383-6480",
            "fax_number": "216-383-6745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18599 LAKE SHORE BLVD STE 207",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441191093",
            "telephone_number": "216-383-0100",
            "fax_number": "216-383-6481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY PRIMARY CARE PRACTICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RIDDLE",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "DIRECTOR BILLING SERVICES",
        "authorized_official_telephone_number": "216-383-6480"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0721731",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Euclid, OH

All providers in Euclid, OH · Prosthetic/Orthotic Supplier in Ohio

Sources for this page

Verify at the official NPI Registry.