Provider Demographics
NPI:1699754705
Name:E.N.T. AND ALLERGY HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:E.N.T. AND ALLERGY HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:BINDER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:440-779-1112
Mailing Address - Street 1:25761 LORAIN RD
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:NORTH OLMSTED
Mailing Address - State:OH
Mailing Address - Zip Code:44070-3327
Mailing Address - Country:US
Mailing Address - Phone:440-779-1112
Mailing Address - Fax:440-779-0247
Practice Address - Street 1:25761 LORAIN RD
Practice Address - Street 2:3RD FLOOR
Practice Address - City:NORTH OLMSTED
Practice Address - State:OH
Practice Address - Zip Code:44070-3327
Practice Address - Country:US
Practice Address - Phone:440-779-1112
Practice Address - Fax:440-779-0247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-17
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2070468Medicaid
OHCA1889OtherMEDICARE RAILROAD
OH2085514Medicaid
OH2085541Medicaid
OH2085550Medicaid
OH0972309Medicaid
OH2085523Medicaid
OHF73001OtherPANUTO
OH2085523Medicaid
OH2085514Medicaid
OHE9250481Medicare PIN
OHE9250483Medicare PIN
OH2085550Medicaid