Basic Information
| Provider Information | |||||||||
| NPI: | 1477937399 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ST. VINCENT CHARITY MEDICAL CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2351 E 22ND ST | ||||||||
| Address2: | 342W | ||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441153111 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2168616200 | ||||||||
| FaxNumber: | 2163637490 | ||||||||
| Practice Location | |||||||||
| Address1: | 2351 E 22ND ST | ||||||||
| Address2: | 342W | ||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441153111 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2168616200 | ||||||||
| FaxNumber: | 2163637490 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2015 | ||||||||
| LastUpdateDate: | 07/10/2015 | ||||||||
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| AuthorizedOfficialLastName: | ALLEN-BANKS | ||||||||
| AuthorizedOfficialFirstName: | NICHOLE | ||||||||
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| AuthorizedOfficialTitleorPosition: | PROGRAM ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 2168616200 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | RES.3626 | OH | Y | Hospitals | General Acute Care Hospital |
No ID Information.