Healthcare Provider Details

I. General information

NPI: 1831423334
Provider Name (Legal Business Name): CAREBRIDGE PALLIATIVE SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2009
Last Update Date: 09/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7625 CAMARGO RD SUITE 200
CINCINNATI OH
45243-3107
US

IV. Provider business mailing address

7625 CAMARGO RD SUITE 200
CINCINNATI OH
45243-3107
US

V. Phone/Fax

Practice location:
  • Phone: 513-528-8150
  • Fax: 513-528-8151
Mailing address:
  • Phone: 513-528-8150
  • Fax: 513-528-8151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084H0002X
TaxonomyHospice and Palliative Medicine (Psychiatry & Neurology) Physician
License Number1852107
License Number StateOH

VIII. Authorized Official

Name: MR. JOSEPH KILLIAN
Title or Position: CEO
Credential:
Phone: 513-528-8150