NPIMap

Organization Active NPI

Healthspan Integrated Care

  • Managed Care Organization Pharmacy
  • Cleveland Heights, OH
National Provider Identifier
1790997773
Registry record updated May 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Managed Care Organization PharmacyTaxonomy code 3336M0003X
License
020033850 Issued in OH
Legal business name
HEALTHSPAN INTEGRATED CARE
Practice address
10 Severance Cir
Cleveland Heights, OH 44118-1533
Phone
(216) 297-3803
Fax
(216) 297-2769
NPI assigned
May 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2014

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

Authorized official

Name
Melanie B Rolsen, RPH
Title
MGR, Pharm Business
Phone
(216) 778-6050

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X 02033850 OH
Managed Care Organization Pharmacy 3336M0003X 020033850 OH Primary

Addresses

Primary practice location

10 Severance Cir
Cleveland Heights, OH 44118-1533

Mailing address

5420 Lancaster Dr
Brooklyn Heights, OH 44131-1832
Phone (216) 749-8408

Other names 1

  • Kaiser Foundation Health Plan Pharmacy Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Healthspan Integrated Care23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399420800000",
    "number": "1790997773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5420 LANCASTER DR",
            "city": "BROOKLYN HEIGHTS",
            "state": "OH",
            "postal_code": "441311832",
            "telephone_number": "216-749-8408",
            "fax_number": "216-749-8426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 SEVERANCE CIR",
            "city": "CLEVELAND HEIGHTS",
            "state": "OH",
            "postal_code": "441181533",
            "telephone_number": "216-297-3803",
            "fax_number": "216-297-2769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSPAN INTEGRATED CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2014-05-07",
        "status": "A",
        "authorized_official_last_name": "ROLSEN",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "MGR, PHARM BUSINESS",
        "authorized_official_telephone_number": "216-778-6050",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "OH",
            "license": "02033850",
            "primary": false
        },
        {
            "code": "3336M0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Managed Care Organization Pharmacy",
            "state": "OH",
            "license": "020033850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kaiser Foundation Health Plan Pharmacy",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Cleveland Heights, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2014; 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.