Provider Demographics
NPI:1114273943
Name:REMEDI SENIORCARE OF OHIO NORTHEAST
Entity Type:Organization
Organization Name:REMEDI SENIORCARE OF OHIO NORTHEAST
Other - Org Name:REMEDI SENIORCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SVP
Authorized Official - Prefix:MR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRONFEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-927-8403
Mailing Address - Street 1:26251 BLUESTONE BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44132-2826
Mailing Address - Country:US
Mailing Address - Phone:216-242-0000
Mailing Address - Fax:877-953-2494
Practice Address - Street 1:26251 BLUESTONE BLVD STE 1
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44132-2826
Practice Address - Country:US
Practice Address - Phone:216-242-0000
Practice Address - Fax:877-953-2494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-30
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336L0003X
OHPSNH0222377503336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy