Healthcare Provider Details

I. General information

NPI: 1720048143
Provider Name (Legal Business Name): BETHESDA HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2006
Last Update Date: 06/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10500 MONTGOMERY RD
CINCINNATI OH
45242
US

IV. Provider business mailing address

10500 MONTGOMERY RD
CINCINNATI OH
45242-4402
US

V. Phone/Fax

Practice location:
  • Phone: 513-569-6518
  • Fax: 513-569-6513
Mailing address:
  • Phone: 513-569-6518
  • Fax: 513-569-6513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number36D345875
License Number StateOH

VIII. Authorized Official

Name: BRIAN KRAUSE
Title or Position: VICE PRESIDENT
Credential:
Phone: 513-569-5126