Provider Demographics
NPI:1912285115
Name:UNIVERSITY OF CINCINNATI MEDICAL CENTER LLC
Entity Type:Organization
Organization Name:UNIVERSITY OF CINCINNATI MEDICAL CENTER LLC
Other - Org Name:UCMC OUTPATIENT PHARMACY WEST CHESTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:HUGH
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:HINDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-585-8204
Mailing Address - Street 1:7675 WELLNESS WAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-2509
Mailing Address - Country:US
Mailing Address - Phone:513-298-7730
Mailing Address - Fax:513-759-1999
Practice Address - Street 1:7675 WELLNESS WAY
Practice Address - Street 2:SUITE 100
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-2509
Practice Address - Country:US
Practice Address - Phone:513-298-7730
Practice Address - Fax:513-759-1999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-22
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
OH0221347503336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2943882Medicaid
2131103OtherPK
OH7237790001Medicare NSC