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General NPI Number Information
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NPI Number | 1649957168
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Entity Type | Organization
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Legal Business Name | BLUE ASH ENDOSCOPY CENTER, LLC
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Dates
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Enumeration Date | 06/28/2023
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 11333 CORNELL PARK DR
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City | CINCINNATI
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State | OH
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Zip | 45242-1813
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Country | US
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Telephone | 513-569-1355
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Fax |
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Provider Business Mailing Address
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Address Line | 2925 VERNON PL STE 100
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City | CINCINNATI
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State | OH
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Zip | 45219-2425
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Country | US
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Telephone | 513-569-1355
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | LAWRENCE FRENI
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Credential |
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Telephone | 786-530-3820
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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