Healthcare Provider Details

I. General information

NPI: 1841205564
Provider Name (Legal Business Name): CITY OF CINCINNATI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 01/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2750 BEEKMAN ST MILLVALE @ HOPPLE HEALTH CENTER
CINCINNATI OH
45225-2049
US

IV. Provider business mailing address

3101 BURNET AVENUE
CINCINNATI OH
45229-3014
US

V. Phone/Fax

Practice location:
  • Phone: 513-352-3192
  • Fax: 513-352-3137
Mailing address:
  • Phone: 513-357-7289
  • Fax: 513-357-7396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number36D894909
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code292200000X
TaxonomyDental Laboratory
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. NOBLE MASERU
Title or Position: HEALTH COMMISSIONER
Credential: PHD MPH
Phone: 513-357-7280