Healthcare Provider Details

I. General information

NPI: 1942255229
Provider Name (Legal Business Name): GERIMED, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 08/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4900 COOPER RD
CINCINNATI OH
45242-6915
US

IV. Provider business mailing address

PO BOX 23128
CINCINNATI OH
45223-0128
US

V. Phone/Fax

Practice location:
  • Phone: 513-793-3362
  • Fax:
Mailing address:
  • Phone: 513-891-7574
  • Fax: 513-793-1032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. EMMANUEL V RIVERA
Title or Position: OWNER
Credential: MD
Phone: 513-569-6780