Provider Demographics
NPI:1730374687
Name:COMMUNITY FAMILY CARE INC
Entity type:Organization
Organization Name:COMMUNITY FAMILY CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:
Authorized Official - Last Name:JAYBER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:440-934-7080
Mailing Address - Street 1:PO BOX 1966
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44036-1966
Mailing Address - Country:US
Mailing Address - Phone:440-366-5600
Mailing Address - Fax:440-366-6766
Practice Address - Street 1:2217 WISTERIA WAY
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:OH
Practice Address - Zip Code:44011-2614
Practice Address - Country:US
Practice Address - Phone:440-934-7080
Practice Address - Fax:440-934-0810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-12
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH080190847OtherPALMETTO GBA RETIRED
OH=========002OtherMEDICAL MUTUAL OF OHIO
OH080190847OtherPALMETTO GBA RETIRED
OH9328301Medicare PIN