Provider Demographics
NPI:1578076477
Name:WINTON HILLS MEDICAL & HEALTH CENTER
Entity Type:Organization
Organization Name:WINTON HILLS MEDICAL & HEALTH CENTER
Other - Org Name:WINMED HEALTH SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:PAIGE
Authorized Official - Middle Name:
Authorized Official - Last Name:TEDESCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-233-7100
Mailing Address - Street 1:1019 LINN ST
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45203-1314
Mailing Address - Country:US
Mailing Address - Phone:513-233-7100
Mailing Address - Fax:513-242-1539
Practice Address - Street 1:1019 LINN ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45203-1314
Practice Address - Country:US
Practice Address - Phone:513-233-7100
Practice Address - Fax:513-242-1539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-14
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
OH022818300-033336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2174330OtherPK
OH0256260Medicaid