Type | Company | [sources] | |||
---|---|---|---|---|---|
Name | Cleveland Back & Paint Mgmt | [sources] | |||
Incorporation date | not available | [sources] | |||
Jurisdiction | not available | [sources] | |||
Country | United States of America | [sources] | |||
Description | Provider ID: 2802695 | [sources] | |||
NPI | 1669585428 | [sources] | |||
Registration number | not available | [sources] | |||
Sector | 21 - Professional Medical Group | [sources] | |||
Address | 2307 W. 14th st. S9S, Cleveland, OH 44113 | [sources] | |||
Last change | Last processed | First seen |
Medical providers excluded or suspended from Ohio's Medicaid program.
United States of America · ODM
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Sanctions | |||||
---|---|---|---|---|---|
Country | Authority | Program | Start date | End date | |
United States of America | Ohio Department of Medicaid | - |
Address | ||
---|---|---|
Full address | Country | |
2307 W. 14th st. S9S, Cleveland, OH 44113 | United States of America |