Provider Demographics
NPI:1033538129
Name:CUYAHOGA COUNTY CORRECTIONS CENTER
Entity Type:Organization
Organization Name:CUYAHOGA COUNTY CORRECTIONS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:IFTIKHAR
Authorized Official - Middle Name:
Authorized Official - Last Name:HUSSAIN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:216-443-6208
Mailing Address - Street 1:1215 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44113-1532
Mailing Address - Country:US
Mailing Address - Phone:216-443-7234
Mailing Address - Fax:216-443-6003
Practice Address - Street 1:1215 W 3RD ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44113-1532
Practice Address - Country:US
Practice Address - Phone:216-443-7234
Practice Address - Fax:216-443-6003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-16
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty