Provider Demographics
NPI:1649036849
Name:EBERLING, JOHN (MBA)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:EBERLING
Suffix:
Gender:M
Credentials:MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7385 HERRICK PARK DR
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-2365
Mailing Address - Country:US
Mailing Address - Phone:440-567-2872
Mailing Address - Fax:
Practice Address - Street 1:7385 HERRICK PARK DR
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236-2365
Practice Address - Country:US
Practice Address - Phone:440-567-2872
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-26
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator