Provider Demographics
NPI:1659471936
Name:ENT & ALLERGY HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:ENT & ALLERGY HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:BINDER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:440-779-1112
Mailing Address - Street 1:25761 LORAIN RD
Mailing Address - Street 2:3RD FL
Mailing Address - City:NORTH OLMSTED
Mailing Address - State:OH
Mailing Address - Zip Code:44070-3327
Mailing Address - Country:US
Mailing Address - Phone:440-779-1112
Mailing Address - Fax:
Practice Address - Street 1:7255 OLD OAK BLVD
Practice Address - Street 2:SUITE #C-307
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44130-3329
Practice Address - Country:US
Practice Address - Phone:440-234-5150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2085523Medicaid
OH2085523Medicaid