Provider Demographics
NPI:1437657236
Name:CIRCLE HEALTH SERVICES
Entity Type:Organization
Organization Name:CIRCLE HEALTH SERVICES
Other - Org Name:CIRCLE HEALTH SERVICES RX PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RCM
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FRECH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-373-2846
Mailing Address - Street 1:4500 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44103-3736
Mailing Address - Country:US
Mailing Address - Phone:216-325-9270
Mailing Address - Fax:216-721-5517
Practice Address - Street 1:12201 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-4310
Practice Address - Country:US
Practice Address - Phone:216-721-4010
Practice Address - Fax:216-721-5517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-26
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0002X
OHPMY.022800200-033336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0269468Medicaid
2175995OtherPK
OH0082924Medicaid