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Organization
ST VINCENT CHARITY MEDICAL CENTER
Active
Organization
ST VINCENT CHARITY MEDICAL CENTER
Active
Other names
St Vincent Charity Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN RUSNACZYK (SENIOR VP & CFO)
(216) 363-7718
Entity
Organization
Contact information
Practice address
2351 E 22ND ST, CLEVELAND, OH 44115-3111
(216) 861-6200
(440) 746-3405
Mailing address
6935 TREELINE DR, SUITE J, BRECKSVILLE, OH 44141-3393
(440) 746-3401
(440) 746-3405
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000157500
ANTHEM
—
01
—
0009438
AETNA US HEALTHCARE
—
01
—
016984000
MAGELLAN BEHAVIORAL HLTH
—
01
—
2137410001
CARESOURCE
OH
05
—
3009523
—
OH
01
—
304978
BLACK LUNG
—
01
—
34189342007
MEDICAL MUTUAL OF OHIO CD
OH
01
—
341893452001
CHAMPUS
—
01
—
341893452005
MEDICAL MUTUAL OF OHIO
OH
01
—
34189345202
BUREAU WORKERS' COMPENSAT
OH
01
—
5000072
UNITED HEALTHCARE
—
01
—
615124400
DEPARTMENT OF LABOR
—
01
—
7649709
PEOPLES HEALTH PLAN
OH
05
—
7649709
—
OH
01
—
81312
QUALCHOICE
OH
Enumeration date
02/15/2006
Last updated
11/17/2011
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