Provider Demographics
NPI:1013907120
Name:PROSCAN WOMENS IMAGING AT REDBANK
Entity Type:Organization
Organization Name:PROSCAN WOMENS IMAGING AT REDBANK
Other - Org Name:PROSCAN WOMENS IMAGING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:HILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-281-3400
Mailing Address - Street 1:4850 RED BANK RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45227-1545
Mailing Address - Country:US
Mailing Address - Phone:513-527-7750
Mailing Address - Fax:513-527-7760
Practice Address - Street 1:4850 RED BANK RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45227-1545
Practice Address - Country:US
Practice Address - Phone:513-527-7750
Practice Address - Fax:513-527-7760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-28
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY86000544Medicaid
OHDC4282OtherRAILROAD MEDICARE
OH2393173Medicaid
OH000000364140OtherANTHEM PIN
OH2393173Medicaid