Provider Demographics
NPI:1972916625
Name:THE DEACONESS HEALTH ASSOCIATIONS FUND, INC.
Entity Type:Organization
Organization Name:THE DEACONESS HEALTH ASSOCIATIONS FUND, INC.
Other - Org Name:DEACONESS MEDICAL MONITORING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HEIDEE
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIESTUHLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-559-2854
Mailing Address - Street 1:615 ELSINORE PL STE 900
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45202-1434
Mailing Address - Country:US
Mailing Address - Phone:513-559-2854
Mailing Address - Fax:
Practice Address - Street 1:615 ELSINORE PL STE 900
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45202-1434
Practice Address - Country:US
Practice Address - Phone:513-559-2854
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-10
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty