Organization
THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CONNIE S AYLWARD (MANAGER, PATIENT ACCOUNTS)
(513) 569-6302
Entity
Organization
Contact information
Practice address
375 DIXMYTH AVE, CINCINNATI, OH 45220-2475
(513) 569-6302
(513) 569-6513
Mailing address
619 OAK ST, CINCINNATI, OH 45206-1613
(513) 569-6302
(513) 569-6513
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000002831
ANTHEM
OH
05
—
0154043
—
KY
05
—
3293485
—
OH
01
—
5020027
UNITED HEALTH CARE
OH
01
—
6460320
AETNA
OH
01
—
90443
AMERIGROUP
OH
Enumeration date
03/20/2006
Last updated
04/20/2008
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