Healthcare Provider Details

I. General information

NPI: 1083352934
Provider Name (Legal Business Name): COMMUNITY WELLNESS CENTRE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2022
Last Update Date: 05/21/2022
Certification Date: 05/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5545 BELMONT AVE
CINCINNATI OH
45224-3188
US

IV. Provider business mailing address

3117 W TOWER AVE
CINCINNATI OH
45238-3411
US

V. Phone/Fax

Practice location:
  • Phone: 740-280-9650
  • Fax:
Mailing address:
  • Phone: 513-470-4163
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. BERNITA WILLIAMS
Title or Position: OWNER
Credential: CDCA, CDC RECOGNIZED
Phone: 513-470-4163