| |
100 Viking Way Cincinnati OH 45246-1139 | |
(513) 864-1545 | |
(513) 552-8511 |
Full Name | |
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Speciality | Clinic/Center |
Location | 100 Viking Way, Cincinnati, Ohio |
Authorized Official Name and Position | Dolores J Lindsay (CEO) |
Authorized Official Contact | 5134833080 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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100 Viking Way Cincinnati OH 45246-1139 Ph: (513) 864-1545 | 100 Viking Way Cincinnati OH 45246-1139 Ph: (513) 864-1545 |
NPI Number | 1174867881 |
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Provider Enumeration Date | 11/19/2012 |
Last Update Date | 10/12/2016 |
Medicare PECOS PAC ID | 8628988318 |
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Medicare Enrollment ID | O20180209000569 |
Identifier | Type | State | Issuer |
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1174867881 | NPI | - | NPPES |
0077085 | Medicaid | OH | |
1174867881 | Other | OH | NPI |
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 |