Provider Demographics
NPI:1215273198
Name:CINCICARES HOME CARE
Entity type:Organization
Organization Name:CINCICARES HOME CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:MYRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-389-7634
Mailing Address - Street 1:8050 BECKETT CENTER DR
Mailing Address - Street 2:SUITE 325
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-5017
Mailing Address - Country:US
Mailing Address - Phone:513-899-7634
Mailing Address - Fax:513-389-7633
Practice Address - Street 1:8050 BECKETT CENTER DR STE 325
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-5023
Practice Address - Country:US
Practice Address - Phone:513-899-7634
Practice Address - Fax:513-389-7633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-20
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
OHFTHH.022259450-033336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy PharmacyGroup - Single Specialty
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2138676OtherPK
OH0082291Medicaid
OH0082291Medicaid