Healthcare Provider Details

I. General information

NPI: 1396255824
Provider Name (Legal Business Name): GEORGE HEMINGWAY LSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2017
Last Update Date: 07/02/2024
Certification Date: 07/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 FAIRGROVE AVE
HAMILTON OH
45011-1966
US

IV. Provider business mailing address

230 LUDLOW ST
HAMILTON OH
45011-2903
US

V. Phone/Fax

Practice location:
  • Phone: 513-785-4895
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: