Provider Demographics
NPI:1013192137
Name:CLEVELAND HOME MEDICAL AND MOBILITY
Entity Type:Organization
Organization Name:CLEVELAND HOME MEDICAL AND MOBILITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:REGISTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-278-4788
Mailing Address - Street 1:11743 STATESVILLE BLVD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:NC
Mailing Address - Zip Code:27013-9419
Mailing Address - Country:US
Mailing Address - Phone:704-278-4596
Mailing Address - Fax:704-278-1676
Practice Address - Street 1:11743 STATESVILLE BLVD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:NC
Practice Address - Zip Code:27013-9419
Practice Address - Country:US
Practice Address - Phone:704-278-4596
Practice Address - Fax:704-278-1676
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CLEVELAND DRUG COMPANY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC00754332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0805671Medicaid