Healthcare Provider Details

I. General information

NPI: 1295832566
Provider Name (Legal Business Name): PEDIATRIC CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8250 WINTON RD STE 103
CINCINNATI OH
45231-5916
US

IV. Provider business mailing address

8250 WINTON RD STE 103
CINCINNATI OH
45231-5916
US

V. Phone/Fax

Practice location:
  • Phone: 513-728-4763
  • Fax: 513-728-4762
Mailing address:
  • Phone: 513-728-4763
  • Fax: 513-728-4762

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. KATHERINE I HICKEY
Title or Position: BUSINESS MANAGER
Credential:
Phone: 513-728-4763