Healthcare Provider Details

I. General information

NPI: 1154342129
Provider Name (Legal Business Name): BETHESDA HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 03/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4750 WESLEY AVE SUITE J
CINCINNATI OH
45212-2276
US

IV. Provider business mailing address

4750 WESLEY AVE SUITE J
CINCINNATI OH
45212-2276
US

V. Phone/Fax

Practice location:
  • Phone: 513-531-5110
  • Fax: 513-569-5199
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number021344000
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. BRETT KIRKPATRICK
Title or Position: DIRECTOR OF SENIOR LINK
Credential:
Phone: 513-612-8430