Organization
WOOSTER CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS LARAWAY (EXECUTIVE VP CHIEF FINANCE OFFICER)
(216) 445-1343
Entity
Organization
Contact information
Practice address
1740 CLEVELAND RD, WOOSTER, OH 44691-2204
(330) 287-4500
Mailing address
6801 BRECKSVILLE RD, STE 20, ATTN: DPC RK2-7, INDEPENDENCE, OH 44131-5062
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000168661
ANTHEM
OH
05
—
2070593
—
OH
Enumeration date
07/14/2006
Last updated
07/29/2025
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