Provider Demographics
NPI:1013947365
Name:MEDICA PLUS LTD
Entity Type:Organization
Organization Name:MEDICA PLUS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETRICA
Authorized Official - Middle Name:
Authorized Official - Last Name:MANOLACHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-221-7121
Mailing Address - Street 1:PO BOX 391414
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-8414
Mailing Address - Country:US
Mailing Address - Phone:440-221-7121
Mailing Address - Fax:440-834-1902
Practice Address - Street 1:4200 WARRENSVILLE CENTER RD
Practice Address - Street 2:SUITE 271
Practice Address - City:WARRENSVILLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44122-7051
Practice Address - Country:US
Practice Address - Phone:440-542-0392
Practice Address - Fax:440-834-1902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35076221M207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2731520Medicaid
OHG99868Medicare UPIN
OH2731520Medicaid