| Cheviot Medical Center Inc | |
|
3502 Boudinot Ave Cincinnati OH 45211-5726 | |
| (513) 481-9100 | |
| (513) 389-7052 |
| Full Name | Cheviot Medical Center Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3502 Boudinot Ave, Cincinnati, Ohio |
| Authorized Official Name and Position | Srilakshmi L Pisati (OWNER) |
| Authorized Official Contact | 5134819100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cheviot Medical Center Inc 3502 Boudinot Ave Cincinnati OH 45211-5726 Ph: (513) 481-9100 | Cheviot Medical Center Inc 3502 Boudinot Ave Cincinnati OH 45211-5726 Ph: (513) 481-9100 |
| NPI Number | 1063532430 |
|---|---|
| Provider Enumeration Date | 03/30/2007 |
| Last Update Date | 07/21/2010 |
| Medicare PECOS PAC ID | 6406804087 |
|---|---|
| Medicare Enrollment ID | O20050111000059 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063532430 | NPI | - | NPPES |
| 2119139 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 35-073706 (Ohio) | Primary |
| Provider Name | Srilakshmi Pisati |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265494447 PECOS PAC ID: 2860440443 Enrollment ID: I20100715001057 |
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