Healthcare Provider Details

I. General information

NPI: 1245037092
Provider Name (Legal Business Name): CVP ASC HOLDINGS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2025
Last Update Date: 02/28/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 IVY GTWY STE 302
CINCINNATI OH
45245-1879
US

IV. Provider business mailing address

15933 CLAYTON RD STE 210
BALLWIN MO
63011-2172
US

V. Phone/Fax

Practice location:
  • Phone: 513-515-6172
  • Fax: 513-984-4240
Mailing address:
  • Phone: 616-588-6593
  • Fax: 616-383-0610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DANIEL MILLER
Title or Position: PRESIDENT
Credential: MD
Phone: 513-234-8773