Provider Demographics
NPI:1144290271
Name:ENDO INC II LLC
Entity type:Organization
Organization Name:ENDO INC II LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:DEAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-451-6001
Mailing Address - Street 1:3652 WERK RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45248-4900
Mailing Address - Country:US
Mailing Address - Phone:513-451-6001
Mailing Address - Fax:513-451-7310
Practice Address - Street 1:3652 WERK RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45248-4900
Practice Address - Country:US
Practice Address - Phone:513-451-6001
Practice Address - Fax:513-451-7310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHEN934861Medicare ID - Type Unspecified