Provider Demographics
NPI:1659268472
Name:CODE BLUE MEDICAL SERVICES, LLC
Entity type:Organization
Organization Name:CODE BLUE MEDICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:DANKO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-677-9117
Mailing Address - Street 1:87 E US HIGHWAY 22 AND 3 STE 800
Mailing Address - Street 2:
Mailing Address - City:MAINEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45039-7843
Mailing Address - Country:US
Mailing Address - Phone:513-677-9117
Mailing Address - Fax:513-677-0045
Practice Address - Street 1:16922 TELGE RD STE 2D
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-1108
Practice Address - Country:US
Practice Address - Phone:513-677-9117
Practice Address - Fax:513-677-0045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2801203Medicaid