Provider Demographics
NPI:1215096128
Name:WINTON HILLS MEDICAL & HEALTH CENTER
Entity type:Organization
Organization Name:WINTON HILLS MEDICAL & HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MIRIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:CRENSHAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-242-1033
Mailing Address - Street 1:5275 WINNESTE AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45232-1130
Mailing Address - Country:US
Mailing Address - Phone:513-242-1033
Mailing Address - Fax:513-242-1539
Practice Address - Street 1:5275 WINNESTE AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45232-1130
Practice Address - Country:US
Practice Address - Phone:513-242-1033
Practice Address - Fax:513-242-1539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0289049Medicaid
9149811Medicare UPIN
OHWI3618451Medicare ID - Type Unspecified