MEDICARE: NEIGHBORHOOD HEALTH CARE, INC.

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	261QF0400X	Federally Qualified Health Center (FQHC)

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	:	1588730402
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEIGHBORHOOD HEALTH CARE, INC.

Provider Business Mailing Address
First Line	:	2415 AUBURN AVE.
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45219-2701
Country	:	US
Telephone Number	:	513-224-4949
Fax Number	:	513-241-4191

Provider Business Practice Location Address
First Line	:	270 SOUTHERN AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45219-3023
Country	:	US
Telephone Number	:	513-363-5658
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. MARCIA A IRVING-RAY
Credential	:	DDS
Telephone Number	:	513-221-4949

Provider Enumeration Date	:	11/24/2006
Last Update Date	:	04/05/2011

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