Provider Demographics
NPI:1528208683
Name:OHCP
Entity Type:Organization
Organization Name:OHCP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:
Authorized Official - First Name:VANAPHOUT
Authorized Official - Middle Name:
Authorized Official - Last Name:SANAPHOL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-732-7533
Mailing Address - Street 1:26241 LAKE SHORE BLVD APT 2257
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44132-1149
Mailing Address - Country:US
Mailing Address - Phone:216-732-7533
Mailing Address - Fax:
Practice Address - Street 1:26241 LAKE SHORE BLVD APT 2257
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44132-1149
Practice Address - Country:US
Practice Address - Phone:216-732-7533
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-03
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 125076 IV251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care