Provider Demographics
NPI:1366130098
Name:HINES PRIMARY CARE, LLC
Entity type:Organization
Organization Name:HINES PRIMARY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:HINES
Authorized Official - Suffix:
Authorized Official - Credentials:APRNCNP
Authorized Official - Phone:513-485-0750
Mailing Address - Street 1:1 N COMMERCE PARK DR STE 221
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45215-3188
Mailing Address - Country:US
Mailing Address - Phone:513-485-0750
Mailing Address - Fax:513-813-3023
Practice Address - Street 1:1 N COMMERCE PARK DR STE 221
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45215-3188
Practice Address - Country:US
Practice Address - Phone:513-485-0750
Practice Address - Fax:513-813-3023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-01
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty