| |
400 Maple St Cincinnati OH 45216-2128 | |
(513) 242-1033 | |
(513) 242-1539 |
Full Name | |
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Speciality | Clinic/Center |
Location | 400 Maple St, Cincinnati, Ohio |
Authorized Official Name and Position | Miriam Crenshaw (CEO) |
Authorized Official Contact | 5132421033 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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5275 Winneste Ave Cincinnati OH 45232-1130 Ph: (513) 242-1033 | 400 Maple St Cincinnati OH 45216-2128 Ph: (513) 242-1033 |
NPI Number | 1003085549 |
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Provider Enumeration Date | 02/28/2008 |
Last Update Date | 09/06/2022 |
Medicare PECOS PAC ID | 6507881406 |
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Medicare Enrollment ID | O20080320000692 |
Identifier | Type | State | Issuer |
---|---|---|---|
1003085549 | NPI | - | NPPES |
2856968 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Oki Kidney Care, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4760 E Galbraith Rd, Ste 217, Cincinnati, OH 45236 Phone: 513-842-2000 | |
Uc Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 234 Goodman St, Ml 665x, Cincinnati, OH 45219 Phone: 513-584-7425 Fax: 513-584-8730 |