Provider Demographics
NPI:1407259849
Name:CLINIC MEDICAL SERVICES COMPANY
Entity Type:Organization
Organization Name:CLINIC MEDICAL SERVICES COMPANY
Other - Org Name:CLEVELAND CLINIC STAR IMAGING DAYTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF ACCTING OFFICER & CONTROLLER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-445-8990
Mailing Address - Street 1:6100 WEST CREEK RD
Mailing Address - Street 2:SUITE 35
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OH
Mailing Address - Zip Code:44131
Mailing Address - Country:US
Mailing Address - Phone:216-642-8165
Mailing Address - Fax:
Practice Address - Street 1:5529 FAR HILLS AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45429-2225
Practice Address - Country:US
Practice Address - Phone:937-435-6674
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CLEVELAND CLINIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-09-30
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty