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NPI Code Detail

MEDICARE: CITY OF CINCINNATI

MEDICARE: CITY OF CINCINNATI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1333600000XPharmacy
23336C0002XClinic Pharmacy020294600OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
22074382OTHERPK

General Provider Information

NPI Number : 1063591949
Entity Type Code : Organization
Provider Name (Legal Business Name) : CITY OF CINCINNATI
Provider Business Mailing Address
First Line : 3917 SPRING GROVE AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45223-3302
Country : US
Telephone Number : 513-357-7649
Fax Number : 513-357-7651
Provider Business Practice Location Address
First Line : 3917 SPRING GROVE AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45223-3302
Country : US
Telephone Number : 513-357-7649
Fax Number : 513-357-7651
Authorized Official
Title or Position : PHARMACY DIRECTOR
Name : QUENTIN NORMAN
Credential : PHARMD
Telephone Number : 513-352-3801
Provider Enumeration Date : 11/03/2006
Last Update Date : 02/14/2017

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Practice Location Address:
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Practice Fax:
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1891018511 — CITY OF CINCINNATI
Practice Location Address:
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1346563061 — CITY OF CINCINNATI
Practice Location Address:
3917 SPRING GROVE AVE
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Practice Phone: 513-357-7600
Practice Fax: 513-352-3939

Directions to “CITY OF CINCINNATI ” Practice Location

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