Provider Demographics
NPI:1871149898
Name:PRIORITY HEALTH CARE, INC
Entity type:Organization
Organization Name:PRIORITY HEALTH CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PROGRAM COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:JACKIE LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:BUECHELE
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:412-983-5599
Mailing Address - Street 1:12409 LORAIN AVE STE B
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44111-3515
Mailing Address - Country:US
Mailing Address - Phone:216-252-7760
Mailing Address - Fax:216-252-7761
Practice Address - Street 1:12409 LORAIN AVE STE B
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44111-3515
Practice Address - Country:US
Practice Address - Phone:216-252-7760
Practice Address - Fax:216-252-7761
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRIORITY HEALTH CARE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-08-15
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty