Provider Demographics
NPI:1316573900
Name:THE METROHEALTH SYSTEM
Entity Type:Organization
Organization Name:THE METROHEALTH SYSTEM
Other - Org Name:GLENVILLE COMMUNITY HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:GEOFF
Authorized Official - Middle Name:A
Authorized Official - Last Name:HIMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-957-2799
Mailing Address - Street 1:2500 METROHEALTH DR # A107
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44109-1998
Mailing Address - Country:US
Mailing Address - Phone:216-778-1639
Mailing Address - Fax:216-778-2338
Practice Address - Street 1:11100 SAINT CLAIR AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44108-1943
Practice Address - Country:US
Practice Address - Phone:216-957-5600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE METROHEALTH SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-03-16
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)