Provider Demographics
NPI:1316272412
Name:SOUTHWEST GENERAL BRUNSWICK EMERGENCY CENTER
Entity type:Organization
Organization Name:SOUTHWEST GENERAL BRUNSWICK EMERGENCY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:RYBAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-887-4701
Mailing Address - Street 1:7123 PEARL RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44130-4975
Mailing Address - Country:US
Mailing Address - Phone:440-842-7990
Mailing Address - Fax:
Practice Address - Street 1:4065 CENTER RD
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:OH
Practice Address - Zip Code:44212-2918
Practice Address - Country:US
Practice Address - Phone:440-842-7990
Practice Address - Fax:440-842-8835
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-07
Last Update Date:2009-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response AttendantGroup - Single Specialty