Healthcare Provider Details
I. General information
NPI: 1467084269
Provider Name (Legal Business Name): VEIN CENTER OF CINCINNATI LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/10/2020
Last Update Date: 07/03/2025
Certification Date: 07/03/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7426 BEECHMONT AVE UNIT 212
CINCINNATI OH
45255-4105
US
IV. Provider business mailing address
PO BOX 32160
LOUISVILLE KY
40232-2160
US
V. Phone/Fax
- Phone: 513-232-2400
- Fax: 513-232-2401
- Phone: 305-642-6593
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2086S0129X |
| Taxonomy | Vascular Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANDREW
HEARN
Title or Position: OWNER
Credential: MD
Phone: 513-232-2400