# MARYMOUNT HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063825743
- **Authorized official:** MICHAEL WASCOVICH (SENIOR DIRECTOR)
- **Authorized official phone:** (216) 445-2357

## Contact information

- **Practice address:** 12300 MCCRACKEN RD, GARFIELD HTS, OH 44125
- **Practice address phone:** (216) 587-8124
- **Practice address fax:** (216) 587-8997
- **Mailing address:** 9500 EUCLID AVE JJ10, CLEVELAND, OH 44195
- **Mailing address phone:** (216) 444-3401
- **Mailing address fax:** (216) 445-0025

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 020031150 | OH | Yes |

## Other

- **Enumeration date:** 06/10/2014
- **Last updated:** 06/10/2014