NPIMap

Organization Active NPI

Northeast Ohio Neighborhood Health Services, Inc.

  • Clinic Pharmacy
  • Cleveland, OH
National Provider Identifier
1659407682
Registry record updated May 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
License
3653210 Issued in OH
Legal business name
NORTHEAST OHIO NEIGHBORHOOD HEALTH SERVICES, INC.
Practice address
12100 Superior Ave
Cleveland, OH 44106-1444
Phone
(216) 851-2600
NPI assigned
Feb 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2008

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

Authorized official

Name
Willie F. Austin
Title
President & Ceo
Phone
(216) 231-7700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X 3653210 OH Primary

Addresses

Primary practice location

12100 Superior Ave
Cleveland, OH 44106-1444

Mailing address

12100 Superior Ave
Cleveland, OH 44106-1444
Phone (216) 851-2600

Other identifiers 1

IdentifierTypeStateIssuer
0154863MedicaidOH

Other names 1

  • Superior Health Center Pharmacy Other name

National Provider Directory

National Provider Directory
Tax ID family
Northeast Ohio Neighbor14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212019200000",
    "number": "1659407682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12100 SUPERIOR AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441061444",
            "telephone_number": "216-851-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12100 SUPERIOR AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441061444",
            "telephone_number": "216-851-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST OHIO NEIGHBORHOOD HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2008-05-29",
        "status": "A",
        "authorized_official_last_name": "AUSTIN",
        "authorized_official_first_name": "WILLIE",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "216-231-7700"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "OH",
            "license": "3653210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0154863",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Superior Health Center Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 May 29, 2008; 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.