Provider Demographics
NPI:1679729396
Name:ANDERSON ENT, INC
Entity Type:Organization
Organization Name:ANDERSON ENT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:M
Authorized Official - Last Name:SCHAINOST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-624-6127
Mailing Address - Street 1:7691 FIVE MILE RD.
Mailing Address - Street 2:SUITE 215
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45230-4348
Mailing Address - Country:US
Mailing Address - Phone:513-624-6127
Mailing Address - Fax:513-624-6142
Practice Address - Street 1:7691 FIVE MILE RD
Practice Address - Street 2:SUITE 215
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45230-4348
Practice Address - Country:US
Practice Address - Phone:513-624-6127
Practice Address - Fax:513-624-6142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-13
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350 60254207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0814560Medicaid
OH0814560Medicaid
OHE28921Medicare UPIN