Provider Demographics
NPI: | 1972752921 |
---|---|
Name: | ST. VINCENT CHARITY HOSPITAL |
Entity type: | Organization |
Organization Name: | ST. VINCENT CHARITY HOSPITAL |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PROGRAM DIRECTOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | RICHARD |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | CHRISTIE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 216-861-6200 |
Mailing Address - Street 1: | 2351 EAST 22ND STREET , |
Mailing Address - Street 2: | ST. VINCENT CHARITY HOSPITAL |
Mailing Address - City: | CLEVELAND |
Mailing Address - State: | OH |
Mailing Address - Zip Code: | 44115 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 216-861-6200 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 2351 E 22ND ST |
Practice Address - Street 2: | |
Practice Address - City: | CLEVELAND |
Practice Address - State: | OH |
Practice Address - Zip Code: | 44115-3111 |
Practice Address - Country: | US |
Practice Address - Phone: | 216-861-6200 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2008-09-15 |
Last Update Date: | 2008-09-15 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
OH | 57-012758 | 282NC0060X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 282NC0060X | Hospitals | General Acute Care Hospital | Critical Access |