Healthcare Provider Details

I. General information

NPI: 1316870942
Provider Name (Legal Business Name): SW OHIO SPECIALTY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 S 2ND ST FL 2 SUITE 220
HAMILTON OH
45011-2811
US

IV. Provider business mailing address

PO BOX 837
HAMILTON OH
45012-0837
US

V. Phone/Fax

Practice location:
  • Phone: 513-454-1111
  • Fax: 513-737-1592
Mailing address:
  • Phone: 513-454-1111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN ROLLER
Title or Position: CEO
Credential: NP
Phone: 513-454-1469