Provider Demographics
NPI:1053835058
Name:CEI PHYSICIANS PSC LLC
Entity Type:Organization
Organization Name:CEI PHYSICIANS PSC LLC
Other - Org Name:CVP SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SN CREDENTIALS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TERI
Authorized Official - Middle Name:J
Authorized Official - Last Name:KNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-569-3741
Mailing Address - Street 1:5950 INNOVATION DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:OH
Mailing Address - Zip Code:45005-5170
Mailing Address - Country:US
Mailing Address - Phone:513-984-5133
Mailing Address - Fax:513-984-4240
Practice Address - Street 1:5950 INNOVATION DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:OH
Practice Address - Zip Code:45005
Practice Address - Country:US
Practice Address - Phone:513-984-5133
Practice Address - Fax:513-984-4240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-01
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0244821Medicaid