Organization
MARYMOUNT HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIKE BENICH (CONTROLLER)
(216) 587-8361
Entity
Organization
Contact information
Practice address
12300 MCCRACKEN RD, SUITE 211, CLEVELAND, OH 44125-2914
(216) 584-4372
Mailing address
12300 MCCRACKEN RD, LORETTO BUILDING, GARFIELD HEIGHTS, OH 44125-2914
(216) 581-0500
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
3073
OH
Other
Enumeration date
01/04/2007
Last updated
08/22/2020
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