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NPI Code Detail

MEDICARE: CITY OF CINCINNATI

MEDICARE: CITY OF CINCINNATI
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
1261QF0400XFederally Qualified Health Center (FQHC)

General Provider Information

NPI Number : 1285980946
Entity Type Code : Organization
Provider Name (Legal Business Name) : CITY OF CINCINNATI
Provider Business Mailing Address
First Line : 3101 BURNET AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45229-3014
Country : US
Telephone Number : 513-357-7288
Fax Number :
Provider Business Practice Location Address
First Line : 1702 GRAND AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45214-1502
Country : US
Telephone Number : 513-357-7208
Fax Number :
Authorized Official
Title or Position : HEALTH COMMISSIONER
Name : DR. NOBLE MASERU
Credential : PHD
Telephone Number : 513-357-7280
Provider Enumeration Date : 07/31/2012
Last Update Date : 07/31/2012

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1598289753 — MR. FERNANDO XAVIER RICO-ALARCON RN
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Directions to “CITY OF CINCINNATI ” Practice Location

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