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Organization

KAISER PERMANENTE

Active
Other names
Ohio Permanente Medical Group
Organization subpart
No

Provider details

NPI number
Authorized official
TOM REVIS (VP CFO)
(216) 265-8844
Entity
Organization

Contact information

Practice address
5410 LANCASTER DR, BROOKLYN HTS, OH 44131
(216) 265-8810
(216) 265-8890
Mailing address
12301 SNOW ROAD, PARMA, OH 44130
(216) 265-8810
(216) 265-8890

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0211372
OH
Enumeration date
09/06/2006
Last updated
01/16/2008
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