Healthcare Provider Details
I. General information
NPI: 1497704209
Provider Name (Legal Business Name): WESTSIDE REGIONAL MEDICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/09/2006
Last Update Date: 01/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3660 EDGEWOOD DR
CINCINNATI OH
45211-1820
US
IV. Provider business mailing address
3660 EDGEWOOD DR
CINCINNATI OH
45211-1820
US
V. Phone/Fax
- Phone: 513-454-1428
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
ROBYN
FINNEGAN
Title or Position: VICE PRESIDENT MANAGED CARE
Credential:
Phone: 513-454-1428