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General NPI Number Information
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NPI Number | 1740154483
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Entity Type | Organization
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Legal Business Name | PROVIDENCE FERTILITY CARE, LLC
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Dates
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Enumeration Date | 10/04/2025
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Last Update Date | 10/04/2025
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Provider Practice Location Address
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Address Line | 2723 POWELL DR
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City | CINCINNATI
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State | OH
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Zip | 45211-7209
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Country | US
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Telephone | 650-417-1118
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Fax | 513-323-6825
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Provider Business Mailing Address
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Address Line | 2723 POWELL DR
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City | CINCINNATI
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State | OH
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Zip | 45211-7209
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Country | US
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Telephone | 650-417-1118
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Fax | 513-323-6825
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | JACOB RODEHEFFER
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Credential |
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Telephone | 650-417-1118
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0050X
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Taxonomy Name | Non-Surgical Family Planning Clinic/Center
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License Number |
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License Number State |
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