1932374782 NPI number — EAR MEDICAL CENTER, INC.

Table of content: (NPI 1932374782)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932374782 NPI number — EAR MEDICAL CENTER, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EAR MEDICAL CENTER, 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:
1932374782
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/23/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6527 COLERAIN AVE
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:
45239-5537
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-385-5000
Provider Business Mailing Address Fax Number:
513-245-5462

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
606 WILSON CREEK RD
Provider Second Line Business Practice Location Address:
STE 140
Provider Business Practice Location Address City Name:
LAWRENCEBURG
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47025-1095
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-537-0031
Provider Business Practice Location Address Fax Number:
812-537-2015
Provider Enumeration Date:
04/23/2008

Additional Information

Authorized Official

Authorized Official Last Name:
HOBEIKA
Authorized Official First Name:
CLAUDE
Authorized Official Middle Name:
PIERRE
Authorized Official Title or Position:
PRESIDENT/MEDICAL DIRECTOR
Authorized Official Telephone Number:
513-385-5000

Provider Taxonomy Codes

  • Taxonomy code: 207YX0901X , with the licence number:  01026640 , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 100094210A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".




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