Organization
ST VINCENT CHARITY MEDICAL CENTER
Active
Other names
St Vincent Charity Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN RUSNACZYK (SENIOR VP & CFO)
(216) 363-7718
Entity
Organization
Contact information
Practice address
2351 E 22ND ST, CLEVELAND, OH 44115-3111
(216) 861-6200
(440) 746-3405
Mailing address
6935 TREELINE DR, SUITE J, BRECKSVILLE, OH 44141-3393
(440) 746-3401
(440) 746-3405
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000157500
ANTHEM
—
01
—
0009438
AETNA US HEALTHCARE
—
01
—
016984000
MAGELLAN BEHAVIORAL HLTH
—
01
—
2137410001
CARESOURCE
OH
05
—
3009523
—
OH
01
—
304978
BLACK LUNG
—
01
—
34189342007
MEDICAL MUTUAL OF OHIO CD
OH
01
—
341893452001
CHAMPUS
—
01
—
341893452005
MEDICAL MUTUAL OF OHIO
OH
01
—
34189345202
BUREAU WORKERS' COMPENSAT
OH
01
—
5000072
UNITED HEALTHCARE
—
01
—
615124400
DEPARTMENT OF LABOR
—
01
—
7649709
PEOPLES HEALTH PLAN
OH
05
—
7649709
—
OH
01
—
81312
QUALCHOICE
OH
Enumeration date
02/15/2006
Last updated
11/17/2011
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