Provider Demographics
NPI:1780935254
Name:SCHEIDLER MEDICAL PREFERRED, LLC
Entity type:Organization
Organization Name:SCHEIDLER MEDICAL PREFERRED, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:HUBBARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-737-0257
Mailing Address - Street 1:543 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-3033
Mailing Address - Country:US
Mailing Address - Phone:513-737-0257
Mailing Address - Fax:513-737-3627
Practice Address - Street 1:543 PARK AVE
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-3033
Practice Address - Country:US
Practice Address - Phone:513-737-0257
Practice Address - Fax:513-737-3627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-25
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0101002Medicaid
OHH300051Medicare PIN
OHDV3997Medicare PIN