Provider Demographics
NPI:1407809320
Name:OHIO CHEST PHYSICIANS LTD
Entity Type:Organization
Organization Name:OHIO CHEST PHYSICIANS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERIM PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:OLGA
Authorized Official - Middle Name:
Authorized Official - Last Name:GORKAVCHUK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-267-5139
Mailing Address - Street 1:PO BOX 932085
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44193-0007
Mailing Address - Country:US
Mailing Address - Phone:330-400-5437
Mailing Address - Fax:330-546-7758
Practice Address - Street 1:15805 PURITAS AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44135-2611
Practice Address - Country:US
Practice Address - Phone:216-267-5139
Practice Address - Fax:216-267-5133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCD4625OtherRAILROAD MEDICARE
OH2365015Medicaid
OHCD6683OtherRAILROAD MEDICARE
OHDB6758OtherRAILROAD MEDICARE
OH2001738Medicaid
OHCD4623OtherRAILROAD MEDICARE
OHCD4624OtherRAILROAD MEDICARE