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General NPI Number Information
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NPI Number | 1205839610
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Entity Type | Organization
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Legal Business Name | KILBOURNE MEDICAL LABORATORIES INC
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Dates
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Enumeration Date | 05/31/2005
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Last Update Date | 06/04/2008
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Provider Practice Location Address
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Address Line | 665 OHIO PIKE
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City | CINCINNATI
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State | OH
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Zip | 45245-2117
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Country | US
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Telephone | 513-752-7300
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Fax | 513-752-7601
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Provider Business Mailing Address
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Address Line | 665 OHIO PIKE
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City | CINCINNATI
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State | OH
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Zip | 45245-2117
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Country | US
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Telephone | 513-752-7300
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Fax | 513-752-7601
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | CINDY SMOTHERMAN
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Credential |
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Telephone | 513-752-7300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 36D0346978
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License Number State | OH
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