Provider Demographics
NPI:1528361169
Name:CCF
Entity Type:Organization
Organization Name:CCF
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:OSAMA
Authorized Official - Middle Name:
Authorized Official - Last Name:ESSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-451-2232
Mailing Address - Street 1:18675 PARKLAND DRIVE APT 403
Mailing Address - Street 2:
Mailing Address - City:SHAKER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44122
Mailing Address - Country:US
Mailing Address - Phone:404-451-2439
Mailing Address - Fax:
Practice Address - Street 1:18675 PARKLAND DR APT 403
Practice Address - Street 2:
Practice Address - City:SHAKER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44122-3467
Practice Address - Country:US
Practice Address - Phone:404-451-2439
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-20
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes281P00000XHospitalsChronic Disease Hospital