Healthcare Provider Details

I. General information

NPI: 1801194246
Provider Name (Legal Business Name): SHADEL LAMB & ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2011
Last Update Date: 03/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4820 RIDGE AVE
CINCINNATI OH
45209-1033
US

IV. Provider business mailing address

2823 QUEENSWOOD DR
CINCINNATI OH
45211-8309
US

V. Phone/Fax

Practice location:
  • Phone: 513-546-5595
  • Fax: 513-931-2207
Mailing address:
  • Phone: 513-546-5595
  • Fax: 513-931-2207

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License NumberPN115186-MEDS
License Number StateOH

VIII. Authorized Official

Name: MRS. SHADEL MARKISE LAMB
Title or Position: LPN
Credential:
Phone: 513-546-5595