Healthcare Provider Details

I. General information

NPI: 1306928072
Provider Name (Legal Business Name): CLERMONT COUNTY COMMUNITY SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 03/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3003 HOSPITAL DR
BATAVIA OH
45103-2689
US

IV. Provider business mailing address

3003 HOSPITAL DR
BATAVIA OH
45103-2689
US

V. Phone/Fax

Practice location:
  • Phone: 513-732-2277
  • Fax: 513-735-8839
Mailing address:
  • Phone: 513-732-2277
  • Fax: 513-735-8839

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: SHEEMA FAROOQUI
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 513-732-2277