Provider Demographics
NPI:1891030623
Name:BETHESDA HOSPITAL, INC
Entity Type:Organization
Organization Name:BETHESDA HOSPITAL, INC
Other - Org Name:HOSPICE OF CINCINNATI
Other - Org Type:Other Name
Authorized Official - Title/Position:SOCIAL WORKER II
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:GOBLE
Authorized Official - Suffix:
Authorized Official - Credentials:LISW-S
Authorized Official - Phone:513-891-7700
Mailing Address - Street 1:4360 COOPER RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-5688
Mailing Address - Country:US
Mailing Address - Phone:513-891-7700
Mailing Address - Fax:513-246-9555
Practice Address - Street 1:4360 COOPER RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-5688
Practice Address - Country:US
Practice Address - Phone:513-891-7700
Practice Address - Fax:513-246-9555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-05
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.1000385.SUP251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based