CCN: 366240 NPI: 1144241324 Organization

WESTERN RESERVE MASONIC COMM

4931 NETTLETON RD
MEDINA, OH 442563232

Contact Information

Phone 3307213000
Fax 3307213279
Enumeration Date 2006-07-22
Last Updated 2015-02-03

Taxonomies

Code: 310400000X License State: OH License: 6114
Code: 314000000X (Primary) License State: OH License: 6113

Inpatient Payment Attributes (IPSF) View Dictionary →

Effective Date:

censusDivision 4

cbsaActualGeographicLocation 17410

providerType 38

vbpAdjustment 0.9819149492

censusDivision 4

cbsaActualGeographicLocation 17410

providerType 38

vbpAdjustment 0.9805758777

censusDivision 0

cbsaActualGeographicLocation 17460

providerType 38

vbpAdjustment 1.0

censusDivision 0

cbsaActualGeographicLocation 17460

providerType 38

vbpAdjustment 0.992

censusDivision 0

cbsaActualGeographicLocation 17460

providerType 38

vbpAdjustment 1.0154588632

censusDivision 0

cbsaActualGeographicLocation 17460

providerType 38

vbpAdjustment 0.9803449243

censusDivision 0

cbsaActualGeographicLocation 17460

providerType 38

vbpAdjustment 0.9986553245

Outpatient Payment Attributes (OPSF) View Dictionary →

No OPSF records found for this provider.