Provider Demographics
NPI:1215234976
Name:CLINIC MEDICAL SERVICES COMPANY
Entity type:Organization
Organization Name:CLINIC MEDICAL SERVICES COMPANY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, BUSINESS OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:KAFITI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-445-5023
Mailing Address - Street 1:6100 W CREEK RD STE 35
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OH
Mailing Address - Zip Code:44131-2133
Mailing Address - Country:US
Mailing Address - Phone:216-642-8165
Mailing Address - Fax:216-642-1064
Practice Address - Street 1:1449 BOARDMAN CANFIELD RD STE 140
Practice Address - Street 2:
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-8070
Practice Address - Country:US
Practice Address - Phone:330-965-7370
Practice Address - Fax:330-965-7377
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CLEVELAND CLINIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-02-16
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty