Provider Demographics
NPI:1033356795
Name:QUEEN CITY HEALTH LLC
Entity Type:Organization
Organization Name:QUEEN CITY HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CPC/MEDICAL BILLER
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:LOU
Authorized Official - Last Name:MULLETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-231-8885
Mailing Address - Street 1:6355 E KEMPER RD
Mailing Address - Street 2:LL1
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45241-2380
Mailing Address - Country:US
Mailing Address - Phone:513-247-0013
Mailing Address - Fax:513-247-0081
Practice Address - Street 1:6355 E KEMPER RD
Practice Address - Street 2:LL1
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45241-2380
Practice Address - Country:US
Practice Address - Phone:513-247-0013
Practice Address - Fax:513-247-0081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-16
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-052084174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty