# AVON MEDICLINIC,LLC

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

## Provider details

- **NPI number:** 1962746958
- **Authorized official:** SANRAE J ONYENEKE LPN (PRESIDENT)
- **Authorized official phone:** (440) 506-5674

## Contact information

- **Practice address:** 1260 ABBE RD N, ELYRIA, OH 44035-1649
- **Practice address phone:** (440) 366-0455
- **Practice address fax:** (440) 281-8839
- **Mailing address:** 1260 ABBE RD N, ELYRIA, OH 44035-1649
- **Mailing address phone:** (440) 366-0455
- **Mailing address fax:** (440) 281-8839

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 261QU0200X | Urgent Care Clinic/Center | — | OH | — |

## Other

- **Enumeration date:** 11/15/2012
- **Last updated:** 05/20/2024