Provider Demographics
NPI:1790772804
Name:CEI PHYSICIANS PSC LLC
Entity Type:Organization
Organization Name:CEI PHYSICIANS PSC LLC
Other - Org Name:CVP SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE CREDENTIALS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:TERI
Authorized Official - Middle Name:J
Authorized Official - Last Name:KNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-569-3741
Mailing Address - Street 1:1945 CEI DRIVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-3311
Mailing Address - Country:US
Mailing Address - Phone:513-569-3741
Mailing Address - Fax:513-569-3941
Practice Address - Street 1:1945 CEI DR
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-5664
Practice Address - Country:US
Practice Address - Phone:513-569-3741
Practice Address - Fax:513-569-3941
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CEI PHYSICIANS PSC LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-10-04
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0813AS261QS0132X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2010737Medicaid
IN200131640Medicaid
KY36001030Medicaid
OH490003385OtherRAILROAD MEDICARE
KY36001030Medicaid