Provider Demographics
NPI:1396714663
Name:BETHESDA HOSPITAL INC
Entity type:Organization
Organization Name:BETHESDA HOSPITAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CROFTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-569-6577
Mailing Address - Street 1:PO BOX 633571
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-3571
Mailing Address - Country:US
Mailing Address - Phone:513-569-6117
Mailing Address - Fax:513-569-6513
Practice Address - Street 1:10500 MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-4402
Practice Address - Country:US
Practice Address - Phone:513-569-6302
Practice Address - Fax:513-569-6513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-17
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH5022913OtherUNITED HEALTH CARE
IN100069540AMedicaid
OH6460275OtherAETNA
OH000000002679OtherANTHEM
OH0684504Medicaid
KY01540426Medicaid
OH195455OtherAMERIGROUP
OH0684504Medicaid
OH0684504Medicaid