Provider Demographics
NPI:1457477291
Name:NORTH OHIO HEART CENTER, INC
Entity Type:Organization
Organization Name:NORTH OHIO HEART CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:THOME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-930-4400
Mailing Address - Street 1:1220 MOORE RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:AVON
Mailing Address - State:OH
Mailing Address - Zip Code:44011-4044
Mailing Address - Country:US
Mailing Address - Phone:440-930-4444
Mailing Address - Fax:440-934-0682
Practice Address - Street 1:6701 ROCKSIDE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:INDEPENDENCE
Practice Address - State:OH
Practice Address - Zip Code:44131-2358
Practice Address - Country:US
Practice Address - Phone:216-621-5000
Practice Address - Fax:216-621-5034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHPENDINGMedicaid
OHNO9913833Medicare ID - Type Unspecified