Provider Demographics
NPI:1154776979
Name:CINCINNATI HEALTH NETWORK, INC
Entity type:Organization
Organization Name:CINCINNATI HEALTH NETWORK, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:AUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MADDOX
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:513-961-0600
Mailing Address - Street 1:40 E MCMICKEN AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45202-6626
Mailing Address - Country:US
Mailing Address - Phone:513-961-0600
Mailing Address - Fax:513-961-0643
Practice Address - Street 1:411 GEST ST STE 1
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45203-1731
Practice Address - Country:US
Practice Address - Phone:513-386-7899
Practice Address - Fax:513-352-6379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-29
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)