MEDICARE: FAMILY SERVICE OF THE CINCINNATI AREA

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	251K00000X	Public Health or Welfare Agency	869542	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356325872
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY SERVICE OF THE CINCINNATI AREA

Provider Business Mailing Address
First Line	:	3730 GLENWAY AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45205-1354
Country	:	US
Telephone Number	:	513-381-6300
Fax Number	:	513-345-8551

Provider Business Practice Location Address
First Line	:	3730 GLENWAY AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45205-1354
Country	:	US
Telephone Number	:	513-381-6300
Fax Number	:	513-345-8551

Authorized Official
Title or Position	:	CEO
Name	:	MR. JAMES J O'NEIL
Credential	:
Telephone Number	:	513-354-5200

Provider Enumeration Date	:	11/30/2005
Last Update Date	:	08/11/2017

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