1225276843 NPI number — CINCINNATI VA MEDICAL CENTER

Table of content: (NPI 1225276843)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225276843 NPI number — CINCINNATI VA MEDICAL CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CINCINNATI VA MEDICAL CENTER
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:
DEPARTMENT OF VETERANS AFFAIRS
Provider Other Organization Name Type Code:
5
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:
1225276843
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/04/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3200 VINE ST
Provider Second Line Business Mailing Address:
539/121
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45220-2213
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-861-3100
Provider Business Mailing Address Fax Number:
513-487-6693

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3200 VINE ST
Provider Second Line Business Practice Location Address:
539/121
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45220-2213
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-861-3100
Provider Business Practice Location Address Fax Number:
513-487-6693
Provider Enumeration Date:
02/04/2009

Additional Information

Authorized Official

Authorized Official Last Name:
LAGERSTRAND
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
P.
Authorized Official Title or Position:
ORTHOTIST
Authorized Official Telephone Number:
513-861-3100

Provider Taxonomy Codes

  • Taxonomy code: 284300000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2024 www.npivalidator.com