| |
636 Prospect Place Cincinnati OH 45229-2916 | |
(513) 363-5522 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 636 Prospect Place, Cincinnati, Ohio |
Authorized Official Name and Position | Marcia A Irving-ray (CEO) |
Authorized Official Contact | 5132214949 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2415 Auburn Ave. Cincinnati OH 45219-2701 Ph: (513) 221-4949 | 636 Prospect Place Cincinnati OH 45229-2916 Ph: (513) 363-5522 |
NPI Number | 1841365954 |
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Provider Enumeration Date | 11/22/2006 |
Last Update Date | 04/05/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1841365954 | NPI | - | NPPES |
2607245 | 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 |