Provider Demographics
NPI:1316015449
Name:PLANNED PARENTHOOD OF GREATER OHIO
Entity Type:Organization
Organization Name:PLANNED PARENTHOOD OF GREATER OHIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON-DOMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-224-2235
Mailing Address - Street 1:PO BOX 933428
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44193-0039
Mailing Address - Country:US
Mailing Address - Phone:234-402-4086
Mailing Address - Fax:234-402-4086
Practice Address - Street 1:2663 CLEVELAND AVENUE NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44709-3393
Practice Address - Country:US
Practice Address - Phone:800-230-7526
Practice Address - Fax:234-402-4086
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PLANNED PARENTHOOD OF GREATER OHIO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-30
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility
Yes261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-SurgicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH728860OtherMEDICAID HMO BUCKEYE
OH0075449Medicaid
OHPL9309731Medicare UPIN
OH0075499Medicaid