Healthcare Provider Details

I. General information

NPI: 1578076477
Provider Name (Legal Business Name): WINTON HILLS MEDICAL & HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2017
Last Update Date: 05/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1019 LINN ST
CINCINNATI OH
45203-1314
US

IV. Provider business mailing address

1019 LINN ST
CINCINNATI OH
45203-1314
US

V. Phone/Fax

Practice location:
  • Phone: 513-233-7100
  • Fax: 513-242-1539
Mailing address:
  • Phone: 513-233-7100
  • Fax: 513-242-1539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number022818300-03
License Number StateOH

VIII. Authorized Official

Name: PAIGE TEDESCO
Title or Position: PHARMACIST
Credential:
Phone: 513-233-7100