Provider Demographics
NPI:1801845474
Name:MEDSOURCE ONE LTD
Entity Type:Organization
Organization Name:MEDSOURCE ONE LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:E
Authorized Official - Last Name:SINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD MPH
Authorized Official - Phone:216-642-7707
Mailing Address - Street 1:8555 SWEET VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:VALLEY VIEW
Mailing Address - State:OH
Mailing Address - Zip Code:44125
Mailing Address - Country:US
Mailing Address - Phone:216-328-2240
Mailing Address - Fax:216-642-7945
Practice Address - Street 1:8555 SWEET VALLEY DR
Practice Address - Street 2:
Practice Address - City:VALLEY VIEW
Practice Address - State:OH
Practice Address - Zip Code:44125
Practice Address - Country:US
Practice Address - Phone:216-328-2240
Practice Address - Fax:216-642-7945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center