Provider Demographics
NPI:1467623751
Name:RONALD A. FREIREICH, D.P.M.
Entity Type:Organization
Organization Name:RONALD A. FREIREICH, D.P.M.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:FREIREICH
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:216-591-1905
Mailing Address - Street 1:28790 CHAGRIN BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WOODMERE
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4638
Mailing Address - Country:US
Mailing Address - Phone:216-591-1905
Mailing Address - Fax:216-591-1961
Practice Address - Street 1:28790 CHAGRIN BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:WOODMERE
Practice Address - State:OH
Practice Address - Zip Code:44122-4638
Practice Address - Country:US
Practice Address - Phone:216-591-1905
Practice Address - Fax:216-591-1961
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-14
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36002473332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4594040001Medicare NSC