Provider Demographics
NPI:1477112308
Name:CITY OF CINCINNATI
Entity Type:Organization
Organization Name:CITY OF CINCINNATI
Other - Org Name:AMBROSE CLEMENT HEALTH CENTER PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/ASST HEALTH COMMISSIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:DOMONIC
Authorized Official - Middle Name:M
Authorized Official - Last Name:HOPSON
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:513-357-7361
Mailing Address - Street 1:3559 READING RD STE 101
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-2689
Mailing Address - Country:US
Mailing Address - Phone:513-357-7403
Mailing Address - Fax:513-357-7405
Practice Address - Street 1:3559 READING ROAD
Practice Address - Street 2:SUITE 101
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229
Practice Address - Country:US
Practice Address - Phone:513-316-6817
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY OF CINCINNATI
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-06-13
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
No333600000XSuppliersPharmacy