Provider Demographics
NPI:1922043918
Name:UNIVERSITY OF CINCINNATI MEDICAL CENTER, LLC
Entity Type:Organization
Organization Name:UNIVERSITY OF CINCINNATI MEDICAL CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VP
Authorized Official - Prefix:
Authorized Official - First Name:HUGH
Authorized Official - Middle Name:R
Authorized Official - Last Name:HINDS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:513-585-8720
Mailing Address - Street 1:3200 BURNET AVENUE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3019
Mailing Address - Country:US
Mailing Address - Phone:513-585-8074
Mailing Address - Fax:513-585-8070
Practice Address - Street 1:234 GOODMAN STREET
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2316
Practice Address - Country:US
Practice Address - Phone:513-584-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0590497Medicaid
LA09275371Medicaid
FL911361400 OPMedicaid
GA000883726X OPMedicaid
AZ874661IPMedicaid
CO68931522 IPMedicaid
ALUNI0003OPMedicaid
CAXHSP31361 IPMedicaid
FL911361400 IPMedicaid
AR159639105Medicaid
AZ874661 OPMedicaid
IN100369340AMedicaid
CO68931522 OPMedicaid
GA000883726X IPMedicaid
KS200258670 AMedicaid
ALUNI0003IPMedicaid
CAXHSP41361 OPMedicaid
ALUNI0003IPMedicaid
ALUNI0003OPMedicaid
GA000883726X OPMedicaid