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
1	333600000X	Pharmacy
2	3336C0002X	Clinic Pharmacy	020253100	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2074381	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457435190
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF CINCINNATI

Provider Business Mailing Address
First Line	:	5818 MADISON RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45227-1708
Country	:	US
Telephone Number	:	513-263-8760
Fax Number	:	513-263-8787

Provider Business Practice Location Address
First Line	:	5818 MADISON RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45227-1708
Country	:	US
Telephone Number	:	513-263-8760
Fax Number	:	513-263-8787

Authorized Official
Title or Position	:	DIRECTOR OF PHARMACY
Name	:	QUENTIN NORMAN
Credential	:	PHARMD
Telephone Number	:	513-352-3801

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	02/14/2017

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Directions to “CITY OF CINCINNATI ” Practice Location

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