Healthcare Provider Details

I. General information

NPI: 1902877574
Provider Name (Legal Business Name): CARDIOLOGY CENTER OF CINCINNATI, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10525 MONTGOMERY RD
CINCINNATI OH
45242-4401
US

IV. Provider business mailing address

10525 MONTGOMERY RD
CINCINNATI OH
45242-4401
US

V. Phone/Fax

Practice location:
  • Phone: 513-745-9800
  • Fax: 513-745-0772
Mailing address:
  • Phone: 513-745-9800
  • Fax: 513-745-0772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: EDWARD J LOUGHERY
Title or Position: PRESIDENT
Credential: MD
Phone: 513-745-9800