1497194237 NPI number — CINCINNATI HOSPITALIST SPECIALIST LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497194237 NPI number — CINCINNATI HOSPITALIST SPECIALIST LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CINCINNATI HOSPITALIST SPECIALIST LLC
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:
Provider Other Organization Name Type Code:
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:
1497194237
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/14/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 706330
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:
45270-6330
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-745-5000
Provider Business Mailing Address Fax Number:
513-791-7800

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9633 STONEMASTERS DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOVELAND
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45140-6210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-317-8453
Provider Business Practice Location Address Fax Number:
513-522-4658
Provider Enumeration Date:
06/14/2013

Additional Information

Authorized Official

Authorized Official Last Name:
BORNOVALI
Authorized Official First Name:
SEREF
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
513-317-8453

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  35-081534 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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