1700861531 NPI number — HAMILTONS HEALTH AID SERVICES, INC

Table of content: (NPI 1700861531)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700861531 NPI number — HAMILTONS HEALTH AID SERVICES, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HAMILTONS HEALTH AID SERVICES, 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:
1700861531
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/17/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6225 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:
45239-6419
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-923-3300
Provider Business Mailing Address Fax Number:
513-741-5520

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6225 COLERAIN 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:
45239-6419
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-923-3300
Provider Business Practice Location Address Fax Number:
513-741-5520
Provider Enumeration Date:
12/14/2005

Additional Information

Authorized Official

Authorized Official Last Name:
ROBERTS
Authorized Official First Name:
KATHLEEN
Authorized Official Middle Name:
M
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
513-923-3300

Provider Taxonomy Codes

  • Taxonomy code: 332BC3200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332B00000X , with the licence number: 22094 , 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)

  • Identifier: 45900271 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8220146 . This is a "UHC" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 90254046 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0252962 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1023844 . This is a "ACM/UHC" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 000000004846 . This is a "ANTHEM" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 51535 . This is a "ABP" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 3100192 . This is a "MEDICAID WAIVER" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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