Provider Demographics
NPI:1881725851
Name:COUNTY OF LORAIN OHIO
Entity type:Organization
Organization Name:COUNTY OF LORAIN OHIO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:HEALTH COMMISSIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:P
Authorized Official - Last Name:COVELL
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:440-322-6367
Mailing Address - Street 1:9880 SOUTH MURRAY RIDGE ROAD
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035
Mailing Address - Country:US
Mailing Address - Phone:440-322-6367
Mailing Address - Fax:440-322-0911
Practice Address - Street 1:9880 SOUTH MURRAY RIDGE ROAD
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035
Practice Address - Country:US
Practice Address - Phone:440-322-6367
Practice Address - Fax:440-322-0911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0252980Medicaid
OHFV92631Medicare PIN