Provider Demographics
NPI:1972601474
Name:NORTH OHIO SURGERY, INC.
Entity Type:Organization
Organization Name:NORTH OHIO SURGERY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARKENRIDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-322-4510
Mailing Address - Street 1:210 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-6431
Mailing Address - Country:US
Mailing Address - Phone:440-322-4510
Mailing Address - Fax:440-322-4991
Practice Address - Street 1:210 E BROAD ST
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-6431
Practice Address - Country:US
Practice Address - Phone:440-322-4510
Practice Address - Fax:440-322-4991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2521293Medicaid
OH2521293Medicaid