Provider Demographics
NPI:1821718016
Name:WINTON HILLS MEDICAL AND HEALTH CENTER, INC
Entity Type:Organization
Organization Name:WINTON HILLS MEDICAL AND HEALTH CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:RUTHETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:TUDOR
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:513-242-1760
Practice Address - Street 1:5275 WINNESTE AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45232-1130
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:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0232000331OtherOHIO STATE BOARD OF PHARMACY