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DEDICATED SENIOR MEDICAL CENTER WEST PARK
NPI 1295368397
Non-Pharmacy Dispensing Site in Cleveland, OH

Active since February 17, 2020CLIA 36D2188018 · Waiver
13719 LORAIN AVE, CLEVELAND, OH 44111(216) 307-3005 Get Directions Write a Review

NPPES record last updated: April 23, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 23, 2020, Feb 17, 2020 (2 updates tracked since 2020).

About Dedicated Senior Medical Center West Park NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DEDICATED SENIOR MEDICAL CENTER WEST PARK (NPI 1295368397) is a healthcare organization registered as a non-pharmacy dispensing site in Cleveland, Ohio and active in the NPI registry since February 2020. The organization holds a CLIA Waiver certificate valid through July 9, 2028 and lists Mary Chen, Owner, as its authorized official.

NPPES Registry Identity

NPI1295368397
Entity TypeOrganization
Primary Taxonomy332900000X
Legal Business NameDEDICATED OHIO HOLDING LLC
Location Address13719 LORAIN AVECleveland, OH 44111-3439
Mailing Address1395 Nw 167th StMiami, FL 33169-5710 · (305) 628-6117
Phone(216) 307-3005
Organization SubpartYes
Authorized OfficialMary ChenOwner · (305) 628-6117
Enumeration DateFebruary 17, 2020
Last NPPES UpdateApril 23, 20202 updates tracked since enumeration
NPPES CertifiedApril 23, 2020
✔ NPI 1295368397 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNon-Pharmacy Dispensing SiteSuppliers
Taxonomy Code332900000X
Definition
A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)
13719 LORAIN AVE, Cleveland, OH 44111
Open in Google Maps ↗

Other Names 1

Doing Business AsDedicated Senior Medical Center West Park

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 36D2188018

Dedicated Senior Medical Center West Park · Cleveland, OH
Active · expires Jul 9, 2028
CLIA Number36D2188018
Laboratory TypePhysician Office
Certificate Effective DateJuly 10, 2026
Certificate Expiration DateJuly 9, 2028
Laboratory DirectorGordon Chen
Laboratory Phone(305) 842-3910
Laboratory LocationDedicated Senior Medical Center West Park13719 Lorain Ave, Cleveland, OH 44111
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHARON WALKER MD
Internal Medicine
13719 LORAIN AVE
CLEVELAND, OH 44111
Cuyahoga County (216) 307-3005
DR. TESSY MERIDORES M.D.
Internal Medicine
13719 LORAIN AVE
CLEVELAND, OH 44111
Cuyahoga County (216) 307-3005
DR. BRADLEY BRENNAN BACKOFF D.P.M
Podiatrist (Foot & Ankle Surgery)
13719 LORAIN AVE
CLEVELAND, OH 44111
Cuyahoga County (216) 307-3005
JOY M MARSHALL M.D.
Family Medicine
13719 LORAIN AVE
CLEVELAND, OH 44111
Cuyahoga County (216) 307-3005
HOANG PHUNG
Internal Medicine
13719 LORAIN AVE
CLEVELAND, OH 44111
Cuyahoga County (216) 307-3005
KENNETH BRYNER CNP
Nurse Practitioner (Adult Health)
13719 LORAIN AVE
CLEVELAND, OH 44111
Cuyahoga County (216) 307-3005
JOSEPH WILLIAM RALL DO
Family Medicine
13719 LORAIN AVE
CLEVELAND, OH 44111
Cuyahoga County (216) 307-3005
DR. SUSMITA MOOKERJEE M.D.
Internal Medicine
13719 LORAIN AVE
CLEVELAND, OH 44111
Cuyahoga County (216) 307-3005

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dedicated Ohio Holding LLC's NPI number?

The NPI number for Dedicated Ohio Holding LLC is 1295368397. It was assigned to this organization in the NPPES registry on February 17, 2020. The provider is doing business as Dedicated Senior Medical Center West Park.

Where is Dedicated Ohio Holding LLC located?

Dedicated Ohio Holding LLC is located at 13719 Lorain Ave, Cleveland, OH 44111. The listed phone number is (216) 307-3005.

What is Dedicated Ohio Holding LLC's specialty?

The primary specialty registered for this NPI is Non-Pharmacy Dispensing Site with taxonomy code 332900000X.

Does Dedicated Ohio Holding LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 36D2188018) is associated with this NPI, valid through July 9, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Dedicated Ohio Holding LLC accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 33 other insurers list Dedicated Ohio Holding LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Dedicated Ohio Holding LLC was last updated on April 23, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.