Provider Demographics
NPI:1699960989
Name:BETHESDA HEALTHCARE INC
Entity type:Organization
Organization Name:BETHESDA HEALTHCARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT BETHESDA HEALTHCARE
Authorized Official - Prefix:MS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHANNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-977-0005
Mailing Address - Street 1:PO BOX 630185
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-0185
Mailing Address - Country:US
Mailing Address - Phone:513-891-7230
Mailing Address - Fax:513-891-7354
Practice Address - Street 1:100 ARROW SPRINGS BLVD
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45036-9864
Practice Address - Country:US
Practice Address - Phone:513-282-7075
Practice Address - Fax:513-282-7076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2008-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Multi-Specialty