Organization
DRAKE PAVILION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD KOB MHA (BUSINESS MANAGER)
(513) 585-0352
Entity
Organization
Contact information
Practice address
2139 AUBURN AVE, CINCINNATI, OH 45219-2906
(513) 585-0352
(513) 585-0340
Mailing address
2139 AUBURN AVE, CINCINNATI, OH 45219-2906
(513) 585-0352
(513) 585-0340
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000318917
ANTHEM OHIO
OH
05
—
2450673
—
OH
Enumeration date
09/07/2005
Last updated
08/22/2020
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