Organization
OUTREACH PROFESSIONAL SERVICES INC
Active
Other names
St Vincent Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY A MOWRER (CREDENTIALING SPECIALIST)
(216) 472-2741
Entity
Organization
Contact information
Practice address
6701 ROCKSIDE RD, SUITE 100, INDEPENDENCE, OH 44131-2358
(216) 328-0418
(216) 328-0847
Mailing address
PO BOX 932127, CLEVELAND, OH 44193-0008
(216) 472-2730
(216) 472-2740
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0251856
—
OH
Enumeration date
05/11/2011
Last updated
10/02/2014
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