Healthcare Provider Details
I. General information
NPI: 1104153378
Provider Name (Legal Business Name): NJOH MEDICAL FOUNDATION AND INTERNATIONAL TRADE INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/10/2009
Last Update Date: 11/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2795 THOMASVILLE CT STE 1326
CINCINNATI OH
45238-3009
US
IV. Provider business mailing address
2795 THOMASVILLE CT STE 1326
CINCINNATI OH
45238-3009
US
V. Phone/Fax
- Phone: 513-389-1971
- Fax: 513-293-3621
- Phone: 513-389-1971
- Fax: 513-293-3621
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 302R00000X |
| Taxonomy | Health Maintenance Organization |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
GABRIEL
NJOH
Title or Position: PRESIDENT/CEO/FOUNDER
Credential:
Phone: 513-293-3621