Provider Demographics
NPI:1801088349
Name:CODE BLUE MEDICAL SERVICES, LLC
Entity type:Organization
Organization Name:CODE BLUE MEDICAL SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:DANKO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-677-9117
Mailing Address - Street 1:PO BOX 643954
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45264-3954
Mailing Address - Country:US
Mailing Address - Phone:513-677-9117
Mailing Address - Fax:513-677-0045
Practice Address - Street 1:87 E US HIGHWAY 22 AND 3
Practice Address - Street 2:
Practice Address - City:MAINEVILLE
Practice Address - State:OH
Practice Address - Zip Code:45039-7841
Practice Address - Country:US
Practice Address - Phone:513-677-9117
Practice Address - Fax:513-677-0045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-17
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1701690207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2801203Medicaid
OH6489200001Medicare PIN
OH2801203Medicaid