Provider Demographics
NPI:1699712075
Name:THE METROHEALTH SYSTEM
Entity type:Organization
Organization Name:THE METROHEALTH SYSTEM
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EVP/CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:DERRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-778-7800
Mailing Address - Street 1:2500 METROHEALTH DR
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44109-1900
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4229 PEARL RD
Practice Address - Street 2:MH SKILLED NRSG SERV@THE SENIOR HEALTH & WELLNESS CTR
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44109
Practice Address - Country:US
Practice Address - Phone:216-957-2442
Practice Address - Fax:216-957-2404
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE METROHEALTH SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-02
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2800231Medicaid
OH0364550001OtherMEDICARE DMERC
OH0364550001OtherMEDICARE DMERC
OH=========-22OtherBWC WORKERS COMPENSATION