Healthcare Provider Details

I. General information

NPI: 1780641225
Provider Name (Legal Business Name): ENDOSCOPY CENTER WEST LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 06/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3654 WERK RD
CINCINNATI OH
45248-4900
US

IV. Provider business mailing address

3654 WERK RD
CINCINNATI OH
45248-4900
US

V. Phone/Fax

Practice location:
  • Phone: 513-451-6001
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: RICHARD L SHARFF JR.
Title or Position: VP/SECRETARY
Credential:
Phone: 205-545-2572