1316945173 NPI number — ANESTHESIA ASSOCIATES OF CINCINNATI, INC

Table of content: (NPI 1316945173)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316945173 NPI number — ANESTHESIA ASSOCIATES OF CINCINNATI, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ANESTHESIA ASSOCIATES OF CINCINNATI, 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:
1316945173
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
265 BROOKVIEW CENTRE WAY STE 400
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KNOXVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37919-4052
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
865-293-5328
Provider Business Mailing Address Fax Number:
865-985-7079

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2139 AUBURN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45219-2906
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-585-0577
Provider Business Practice Location Address Fax Number:
513-585-3291
Provider Enumeration Date:
07/14/2005

Additional Information

Authorized Official

Authorized Official Last Name:
MESROBIAN
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
414-962-4350

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 367500000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 2711891 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0338156 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2672059 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6592911 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2326512 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2705335 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100001430 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".




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