Provider Demographics
NPI:1790160331
Name:CORE MEDICAL GROUP
Entity Type:Organization
Organization Name:CORE MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:PINGHERO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:330-221-1968
Mailing Address - Street 1:7050 BIDDULPH RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:OH
Mailing Address - Zip Code:44144-3312
Mailing Address - Country:US
Mailing Address - Phone:216-749-7888
Mailing Address - Fax:216-749-6660
Practice Address - Street 1:7050 BIDDULPH RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:OH
Practice Address - Zip Code:44144-3312
Practice Address - Country:US
Practice Address - Phone:216-749-7888
Practice Address - Fax:216-749-6660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-24
Last Update Date:2015-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty