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General NPI Number Information
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NPI Number | 1811267578
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Entity Type | Organization
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Legal Business Name | SENIOR LINK
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Dates
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Enumeration Date | 01/11/2012
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Last Update Date | 01/11/2012
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Provider Practice Location Address
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Address Line | 4750 WESLEY AVE
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City | CINCINNATI
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State | OH
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Zip | 45212-2244
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Country | US
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Telephone | 513-531-5110
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Fax |
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Provider Business Mailing Address
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Address Line | 6135 ROSS RD
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City | FAIRFIELD
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State | OH
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Zip | 45014-5511
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Country | US
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Telephone | 513-203-1489
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Fax |
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Authorized Official
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Title or Position | RN
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Name | MS. SHIRLEY ANN BIDDLE
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Credential | BSN
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Telephone | 513-458-8872
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | RN284781
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License Number State | OH
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