Provider Demographics
NPI:1306145040
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
Mailing Address - Street 2:SUITE 35
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OH
Mailing Address - Zip Code:44131-2177
Mailing Address - Country:US
Mailing Address - Phone:216-642-8165
Mailing Address - Fax:
Practice Address - Street 1:6096 E MAIN ST
Practice Address - Street 2:SUITE 100
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-4302
Practice Address - Country:US
Practice Address - Phone:614-751-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CLEVELAND CLINIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-03-21
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty