MEDICARE: ENDO INC II LLC

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
1	207RG0100X	Gastroenterology Physician

General Provider Information

NPI Number	:	1144290271
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENDO INC II LLC

Provider Business Mailing Address
First Line	:	3652 WERK RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45248-4900
Country	:	US
Telephone Number	:	513-451-6001
Fax Number	:	513-451-7310

Provider Business Practice Location Address
First Line	:	3652 WERK RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45248-4900
Country	:	US
Telephone Number	:	513-451-6001
Fax Number	:	513-451-7310

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	ANDREW DEAK
Credential	:	MD
Telephone Number	:	513-451-6001

Provider Enumeration Date	:	01/23/2006
Last Update Date	:	08/22/2020

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