Provider Demographics
NPI:1093501959
Name:WEST EXPRESS WEIGHT LOSS COMPANY
Entity type:Organization
Organization Name:WEST EXPRESS WEIGHT LOSS COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLETHEA
Authorized Official - Middle Name:
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:216-374-9519
Mailing Address - Street 1:4620 BRADFORD RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44121-3851
Mailing Address - Country:US
Mailing Address - Phone:216-316-7366
Mailing Address - Fax:
Practice Address - Street 1:4620 BRADFORD RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44121-3851
Practice Address - Country:US
Practice Address - Phone:216-316-7366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RB0002XAllopathic & Osteopathic PhysiciansInternal MedicineObesity MedicineGroup - Single Specialty