MEDICARE: CINCINNATI ASC 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	261QA1903X	Ambulatory Surgical Clinic/Center	0457AS	OH

Other Identifiers

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

General Provider Information

NPI Number	:	1780656801
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CINCINNATI ASC LLC

Provider Business Mailing Address
First Line	:	1A BURTON HILLS BLVD
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37215-6187
Country	:	US
Telephone Number	:	615-665-1283
Fax Number	:

Provider Business Practice Location Address
First Line	:	9275 MONTGOMERY RD
Second Line	:	SUITE 400
City	:	CINCINNATI
State	:	OH
Zip	:	45242-7779
Country	:	US
Telephone Number	:	513-936-4518
Fax Number	:	513-936-4517

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JEFFREY E. SNODGRASS
Credential	:
Telephone Number	:	615-665-1283

Provider Enumeration Date	:	02/02/2006
Last Update Date	:	06/23/2022

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