Provider Demographics
NPI:1376988063
Name:MCGREGORPACE
Entity Type:Organization
Organization Name:MCGREGORPACE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:CONN
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:216-851-8200
Mailing Address - Street 1:2373 EUCLID HEIGHTS BLVD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44106-2716
Mailing Address - Country:US
Mailing Address - Phone:216-741-3580
Mailing Address - Fax:216-791-3281
Practice Address - Street 1:2373 EUCLID HEIGHTS BLVD
Practice Address - Street 2:
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44106-2716
Practice Address - Country:US
Practice Address - Phone:216-741-3580
Practice Address - Fax:216-791-3281
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MCGREGOR AT OVERLOOK
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-05-08
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization