Healthcare Provider Details

I. General information

NPI: 1396941670
Provider Name (Legal Business Name): BETHESDA HEALTHCARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2007
Last Update Date: 11/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 PFEIFFER RD
CINCINNATI OH
45242-5862
US

IV. Provider business mailing address

PO BOX 630185
CINCINNATI OH
45263-0185
US

V. Phone/Fax

Practice location:
  • Phone: 513-985-6736
  • Fax: 513-985-6786
Mailing address:
  • Phone: 513-891-7230
  • Fax: 513-891-7354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number StateOH

VIII. Authorized Official

Name: MS. PAMELA SHANNON
Title or Position: VP
Credential:
Phone: 513-977-0005