Provider Demographics
NPI:1992045256
Name:ANNAVA LLC
Entity Type:Organization
Organization Name:ANNAVA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHEEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MERHOLZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-212-6205
Mailing Address - Street 1:35104 EUCLID AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WILLOUGHBY
Mailing Address - State:OH
Mailing Address - Zip Code:44094-4516
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:35104 EUCLID AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-4516
Practice Address - Country:US
Practice Address - Phone:440-212-6205
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-25
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty