Provider Demographics
NPI:1003588450
Name:BETHESDA HOSPITAL INC
Entity Type:Organization
Organization Name:BETHESDA HOSPITAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:REILLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-246-5675
Mailing Address - Street 1:4623 WESLEY AVE STE N
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-2272
Mailing Address - Country:US
Mailing Address - Phone:513-569-6071
Mailing Address - Fax:833-347-5635
Practice Address - Street 1:4623 WESLEY AVE STE N
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45212-2272
Practice Address - Country:US
Practice Address - Phone:513-569-6071
Practice Address - Fax:833-347-5635
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BETHESDA HOSPITAL INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-10-04
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy