Healthcare Provider Details

I. General information

NPI: 1518112317
Provider Name (Legal Business Name): MEDRX, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2008
Last Update Date: 11/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8000 5 MILE RD SUITE 335
CINCINNATI OH
45230-2163
US

IV. Provider business mailing address

8000 5 MILE RD SUITE 335
CINCINNATI OH
45230-2163
US

V. Phone/Fax

Practice location:
  • Phone: 513-624-7246
  • Fax: 513-624-6900
Mailing address:
  • Phone: 513-624-7246
  • Fax: 513-624-6900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number34008823
License Number StateOH

VIII. Authorized Official

Name: DR. MUKARRAM ALI KHAN
Title or Position: OWNER
Credential: D.O.
Phone: 513-624-7246