1912929589 NPI number — UNIVERSITY NEUROLOGY INC

Table of content: (NPI 1912929589)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912929589 NPI number — UNIVERSITY NEUROLOGY INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIVERSITY NEUROLOGY INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
DBA ARING NEUROLOGY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1912929589
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/09/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2830 VICTORY PKWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45206-1785
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-245-3637
Provider Business Mailing Address Fax Number:
513-475-7259

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
222 PIEDMONT AVE
Provider Second Line Business Practice Location Address:
SUITE 3200
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45219-2485
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-475-8730
Provider Business Practice Location Address Fax Number:
513-475-8033
Provider Enumeration Date:
07/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MURPHY
Authorized Official First Name:
LAURA
Authorized Official Middle Name:
Authorized Official Title or Position:
CREDENTIALING COORDINATOR
Authorized Official Telephone Number:
513-245-3637

Provider Taxonomy Codes

  • Taxonomy code: 103G00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084N0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 65911919 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100016010B , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0477256 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 78904679 . This is a "KY MEDICAID FOR NURSE PRACTIONER'S" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 100016010A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".




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