Provider Demographics
NPI:1740098375
Name:PARRISH, JONATHAN ROSS JR
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:ROSS
Last Name:PARRISH
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6905 BAYLISS AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44103-1515
Mailing Address - Country:US
Mailing Address - Phone:216-744-3747
Mailing Address - Fax:
Practice Address - Street 1:6905 BAYLISS AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44103-1515
Practice Address - Country:US
Practice Address - Phone:216-744-3747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH385HR2050X, 343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2050XRespite Care FacilityRespite CareRespite Care Camp
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)