Healthcare Provider Details

I. General information

NPI: 1780656801
Provider Name (Legal Business Name): CINCINNATI ASC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 06/23/2022
Certification Date: 06/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9275 MONTGOMERY RD SUITE 400
CINCINNATI OH
45242-7779
US

IV. Provider business mailing address

1A BURTON HILLS BLVD
NASHVILLE TN
37215-6187
US

V. Phone/Fax

Practice location:
  • Phone: 513-936-4518
  • Fax: 513-936-4517
Mailing address:
  • Phone: 615-665-1283
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number0457AS
License Number StateOH

VIII. Authorized Official

Name: MR. JEFFREY E. SNODGRASS
Title or Position: PRESIDENT
Credential:
Phone: 615-665-1283