Provider Demographics
NPI:1043489388
Name:DR. LEONE LISA PEEPLES
Entity Type:Organization
Organization Name:DR. LEONE LISA PEEPLES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEONE
Authorized Official - Middle Name:LISA
Authorized Official - Last Name:PEEPLES
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:216-561-3303
Mailing Address - Street 1:3461 WARRENSVILLE CENTER RD
Mailing Address - Street 2:SUITE # 201
Mailing Address - City:SHAKER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5260
Mailing Address - Country:US
Mailing Address - Phone:216-561-3303
Mailing Address - Fax:216-561-7790
Practice Address - Street 1:3461 WARRENSVILLE CENTER RD
Practice Address - Street 2:SUITE # 201
Practice Address - City:SHAKER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44122-5260
Practice Address - Country:US
Practice Address - Phone:216-561-3303
Practice Address - Fax:216-561-7790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-20
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36-00-2700332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH5835180001Medicare NSC