Provider Demographics
NPI:1750655478
Name:CINCINNATI HEALTH NETWORK, INC
Entity Type:Organization
Organization Name:CINCINNATI HEALTH NETWORK, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:BENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-961-0600
Mailing Address - Street 1:2825 BURNET AVE STE 232-234
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2426
Mailing Address - Country:US
Mailing Address - Phone:513-961-0600
Mailing Address - Fax:513-961-0643
Practice Address - Street 1:40 E MCMICKEN AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45202-6549
Practice Address - Country:US
Practice Address - Phone:513-961-0600
Practice Address - Fax:513-961-0643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-27
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health