MEDICARE: CARDIOSOLUTION LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0011X	Interventional Cardiology Physician

General Provider Information

NPI Number	:	1225378300
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARDIOSOLUTION LLC

Provider Business Mailing Address
First Line	:	4270 GLENDALE MILFORD RD
Second Line	:
City	:	BLUE ASH
State	:	OH
Zip	:	45242-3704
Country	:	US
Telephone Number	:	513-618-2394
Fax Number	:	513-618-2395

Provider Business Practice Location Address
First Line	:	4270 GLENDALE MILFORD RD
Second Line	:
City	:	BLUE ASH
State	:	OH
Zip	:	45242-3704
Country	:	US
Telephone Number	:	513-618-2394
Fax Number	:	513-618-2395

Authorized Official
Title or Position	:	CEO
Name	:	PERRIN PEACOCK
Credential	:
Telephone Number	:	513-618-2394

Provider Enumeration Date	:	02/26/2013
Last Update Date	:	02/26/2013

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Directions to “CARDIOSOLUTION LLC ” Practice Location

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