Provider Demographics
NPI:1083656847
Name:THE METROHEALTH SYSTEM
Entity Type:Organization
Organization Name:THE METROHEALTH SYSTEM
Other - Org Name:THE ELISABETH SEVERANCE PRENTISS CTR FOR SKILLED NURSING MHCSNC TPC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR VP CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-778-5016
Mailing Address - Street 1:4229 PEARL RD
Mailing Address - Street 2:PFS DEPT ATTN LINDA GREENHILL PFS SPVR
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44109-1998
Mailing Address - Country:US
Mailing Address - Phone:216-957-2442
Mailing Address - Fax:216-957-2404
Practice Address - Street 1:3525 SCRANTON RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44109-1960
Practice Address - Country:US
Practice Address - Phone:216-957-2442
Practice Address - Fax:216-957-2404
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE METROHEALTH SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-13
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2206400Medicaid
OH2206400Medicaid
OH365787Medicare ID - Type UnspecifiedMEDICARE
OH2206400Medicaid
OH0364550002Medicare NSC