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General NPI Number Information
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NPI Number | 1801829130
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Entity Type | Organization
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Legal Business Name | CINCINNATI HEALTH CARE GROUP PSC
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 12/18/2007
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Provider Practice Location Address
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Address Line | 525 ALEXANDRIA PIKE SUITE 300
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City | SOUTHGATE
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State | KY
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Zip | 41071-3290
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Country | US
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Telephone | 859-957-1080
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Fax |
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Provider Business Mailing Address
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Address Line | 334 THOMAS MORE PKWY SUITE 200
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City | CRESTVIEW HILLS
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State | KY
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Zip | 41017-3464
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | MR. KEN FOLZ
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Credential |
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Telephone | 859-957-1080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 27527
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License Number State | KY
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