Healthcare Provider Details

I. General information

NPI: 1164180931
Provider Name (Legal Business Name): UZIMA REJUVENATION STATION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2021
Last Update Date: 11/29/2021
Certification Date: 11/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7743 COX LN
WEST CHESTER OH
45069-6549
US

IV. Provider business mailing address

PO BOX 1356
HAMILTON OH
45012-1356
US

V. Phone/Fax

Practice location:
  • Phone: 513-278-7668
  • Fax:
Mailing address:
  • Phone: 513-278-7668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. TONI TIPTON
Title or Position: CO-OWNER
Credential: APRN
Phone: 513-646-7146