Provider Demographics
NPI:1043364235
Name:NORTHCOAST HEALTHCARE MANAGEMENT SVC.LTD
Entity type:Organization
Organization Name:NORTHCOAST HEALTHCARE MANAGEMENT SVC.LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EVP BUSINESS DEVELOPMENT & REIMBURS
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:KONOPKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-591-2000
Mailing Address - Street 1:4199 KINROSS LAKES PKWY STE 220
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44286-9394
Mailing Address - Country:US
Mailing Address - Phone:440-212-8828
Mailing Address - Fax:216-591-2500
Practice Address - Street 1:4199 KINROSS LAKES PKWY STE 220
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:OH
Practice Address - Zip Code:44286-9394
Practice Address - Country:US
Practice Address - Phone:440-212-8828
Practice Address - Fax:216-591-2500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000374253OtherANTHEM BLUE CROSS BLUE SH
OH000000301940OtherANTHEM BLUE CROSS BLUE SH
OH000000157514OtherANTHEM BLUE CROSS BLUE SH
OH000000156520OtherANTHEM BLUE CROSS BLUE SH
OH000000203425OtherANTHEM BLUE CROSS BLUE SH
OH000000320550OtherANTHEM BLUE CROSS BLUE SH
OH000000156520OtherANTHEM BLUE CROSS BLUE SH
OH=========001OtherMEDICAL MUTUAL OF OHIO
OH=========004OtherMEDICAL MUTUAL OF OHIO
OH000000374253OtherANTHEM BLUE CROSS BLUE SH