Organization
WILLOUGHBY ASC LLC
Active
Other names
CDH Endoscopy Center
Organization subpart
No
Provider details
NPI number
Authorized official
PHILLIP A. CLENDENIN (PRESIDENT)
(615) 665-1283
Entity
Organization
Contact information
Practice address
34940 RIDGE RD, SUITE B, WILLOUGHBY, OH 44094-4196
(440) 953-8568
(440) 953-4429
Mailing address
34940 RIDGE RD, SUITE B, WILLOUGHBY, OH 44094-4196
(440) 953-8568
(440) 953-4429
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
0389AS
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2039645
—
OH
Enumeration date
02/02/2006
Last updated
09/07/2023
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