Organization
CRESTMONT NURSING HOME NORTH CORP
Active
Other names
Crestmont North - Laboratory
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NORMAN A. FOX JR. (SECRETARY / TREASURER)
(440) 617-2103
Entity
Organization
Contact information
Practice address
13330 DETROIT AVE, LAKEWOOD, OH 44107-2850
(216) 228-9550
Mailing address
24340 SPERRY DR, WESTLAKE, OH 44145-1565
(440) 617-2103
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
36D0929858
OH
Other
Enumeration date
06/24/2008
Last updated
06/24/2008
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