AMERIPATH CINCINNATI INC

Provider Demographics

• NPI: 1881666741
• Name: AMERIPATH CINCINNATI INC
• Entity Type: Organization
• Organization Name: AMERIPATH CINCINNATI INC
• Other - Org Name: RICHFIELD LAB OF DERMATOPATHOLOGY
• Other - Org Type: Doing Business As
• Authorized Official - Title/Position: VICE PRESIDENT
• Authorized Official - First Name: KRISTIE
• Authorized Official - Middle Name: M
• Authorized Official - Last Name: DOLAN
• Authorized Official - Phone: 866-697-8378
• Mailing Address - Street 1: 14275 MIDWAY RD STE 400
• Mailing Address - City: ADDISON
• Mailing Address - State: TX
• Mailing Address - Zip Code: 75001-3661
• Mailing Address - Country: US
• Mailing Address - Fax: 610-271-4245
• Practice Address - Street 1: 6700 STEGER DR STE A
• Practice Address - City: CINCINNATI
• Practice Address - State: OH
• Practice Address - Zip Code: 45237-3046
• Practice Address - Country: US
• Practice Address - Phone: 800-541-8531
• Practice Address - Fax: 513-745-8335
• EIN: <UNAVAIL>
• Is Organization Subpart?: Yes
• Parent Organization LBN: AMERIPATH INC
• Parent Organization TIN: <UNAVAIL>
• Enumeration Date: 2006-02-06
• Last Update Date: 2024-01-18

Provider Licenses

State	License ID	Taxonomies
OH	36D0346613	207ZP0102X, 291U00000X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	291U00000X	Laboratories	Clinical Medical Laboratory
No	207ZP0102X	Allopathic & Osteopathic Physicians	Pathology	Anatomic Pathology & Clinical Pathology	Group - Single Specialty

Provider Identifiers

State	Identifier ID	ID Type	Issuer
IN	100003810A	Medicaid
PA	102209715 0001	Medicaid
NC	7001336	Medicaid
CO	86086049	Medicaid
OH	221530310	Other	MC RR
NM	68306	Medicaid
FL	9141375 00	Medicaid
CA	XPY186016	Medicaid
OH	000000003310	Other	BCBS
KS	100357710B	Medicaid
KY	7100043710	Medicaid
OH	0505331	Medicaid
KS	100357710A	Medicaid
MI	164246223	Medicaid
AZ	342100	Medicaid
GA	000777917A	Medicaid
IA	506428	Medicaid
MN	1881666741	Medicaid
WI	1881666741	Medicaid
WV	3810012030	Medicaid
NE	10025701400	Medicaid
IN	200912300 A	Medicaid
MO	703803304	Medicaid
WI	1881666741	Medicaid
KY	7100043710	Medicaid