Provider Demographics
NPI:1215475819
Name:CINCINNATI HEALTH DEPARTMENT
Entity type:Organization
Organization Name:CINCINNATI HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APN STUDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:L
Authorized Official - Last Name:DALY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:513-515-2875
Mailing Address - Street 1:887 LAVERTY LN
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45230-3511
Mailing Address - Country:US
Mailing Address - Phone:513-515-2875
Mailing Address - Fax:
Practice Address - Street 1:2750 BEEKMAN ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45225-2049
Practice Address - Country:US
Practice Address - Phone:513-352-3192
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-03
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.289183261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health