Provider Demographics
NPI:1770552002
Name:BETHESDA HOSPITAL INC
Entity type:Organization
Organization Name:BETHESDA HOSPITAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER, PATIENT ACCOUNTS
Authorized Official - Prefix:
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:S
Authorized Official - Last Name:AYLWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-569-6302
Mailing Address - Street 1:619 OAK ST
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45206-1613
Mailing Address - Country:US
Mailing Address - Phone:513-569-6302
Mailing Address - Fax:513-569-6513
Practice Address - Street 1:10500 MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-4402
Practice Address - Country:US
Practice Address - Phone:513-569-6302
Practice Address - Fax:513-569-6513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH5020027OtherUNITED HEALTH CARE
OH6460275OtherAETNA
OH195455OtherAMERIGROUP
KY01540426Medicaid
OH0684504Medicaid
OH000000333887OtherANTHEM
OH6460275OtherAETNA
OH195455OtherAMERIGROUP
OH36T179Medicare ID - Type UnspecifiedREHAB