Provider Demographics
NPI:1366998106
Name:METROHEALTH MEDICAL CENTER
Entity type:Organization
Organization Name:METROHEALTH MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARLISE
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:MSN-FNP-C
Authorized Official - Phone:216-577-3215
Mailing Address - Street 1:26500 AMHEARST CIR
Mailing Address - Street 2:APT 206
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-8502
Mailing Address - Country:US
Mailing Address - Phone:216-577-3215
Mailing Address - Fax:
Practice Address - Street 1:26500 AMHEARST CIR
Practice Address - Street 2:APT 206
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-8502
Practice Address - Country:US
Practice Address - Phone:216-577-3215
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.019801261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain