Provider Demographics
NPI:1679990386
Name:CUMMINGS WALCOTT & DAVID CORPORATION
Entity Type:Organization
Organization Name:CUMMINGS WALCOTT & DAVID CORPORATION
Other - Org Name:CWD AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:EULAH
Authorized Official - Middle Name:DARLENE
Authorized Official - Last Name:DAVID-CUMMINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-862-5125
Mailing Address - Street 1:20109 LONGBROOK RD
Mailing Address - Street 2:
Mailing Address - City:WARRENSVILLE HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44128-2826
Mailing Address - Country:US
Mailing Address - Phone:216-862-5125
Mailing Address - Fax:216-862-0729
Practice Address - Street 1:20109 LONGBROOK RD
Practice Address - Street 2:
Practice Address - City:WARRENSVILLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44128-2826
Practice Address - Country:US
Practice Address - Phone:216-862-5125
Practice Address - Fax:216-862-0729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-20
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0094424Medicaid