Provider Demographics
NPI:1205806320
Name:ROBERT J SCHRIMPF AND THOMAS M SCHRIMPF MDS
Entity type:Organization
Organization Name:ROBERT J SCHRIMPF AND THOMAS M SCHRIMPF MDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:M
Authorized Official - Last Name:SCHRIMPF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-598-5102
Mailing Address - Street 1:5630 BRIDGETOWN RD
Mailing Address - Street 2:STE 4
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45248
Mailing Address - Country:US
Mailing Address - Phone:513-598-5102
Mailing Address - Fax:513-598-5104
Practice Address - Street 1:5630 BRIDGETOWN RD
Practice Address - Street 2:STE 4
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45248
Practice Address - Country:US
Practice Address - Phone:513-598-5102
Practice Address - Fax:513-598-5104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-23
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207W00000X
OH01032268A207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0848800Medicaid
OH9935111Medicare PIN