1588620850 NPI number — UNIVERSITY INTERNAL MEDICINE ASSOCIATES, INC.

Table of content: (NPI 1588620850)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588620850 NPI number — UNIVERSITY INTERNAL MEDICINE ASSOCIATES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIVERSITY INTERNAL MEDICINE ASSOCIATES, 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:
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:
1588620850
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/03/2011
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:
CENTRAL CREDENTIALING
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:
513-245-3431
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:
STE 6000
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45219-4231
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-245-3600
Provider Business Practice Location Address Fax Number:
513-245-3672
Provider Enumeration Date:
04/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
FORD
Authorized Official First Name:
TIPTON
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
513-558-4231

Provider Taxonomy Codes

  • Taxonomy code: 207RA0201X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RC0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RE0101X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RG0100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RH0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RI0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RI0011X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RI0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RN0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RP1001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RR0500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RX0202X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363A00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: CF8930 . This is a "RAIL ROAD MEDICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 2445116 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: CC3432 . This is a "RAIL ROAD MEDICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: CD4194 . This is a "RAIL ROAD MEDICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 78902558 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: CN4337 . This is a "RAIL ROAD MEDICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: CH9791 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 100094000 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: CB4920 . This is a "RAIL ROAD MEDICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 200430710 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 65906893 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 95901161 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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