Provider Demographics
NPI:1629209820
Name:CINCINNATI PAIN MANAGEMENT CENTER, LLC
Entity type:Organization
Organization Name:CINCINNATI PAIN MANAGEMENT CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAJBIR
Authorized Official - Middle Name:S
Authorized Official - Last Name:MINHAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-312-5670
Mailing Address - Street 1:5240 E GALBRAITH RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-2822
Mailing Address - Country:US
Mailing Address - Phone:513-312-5670
Mailing Address - Fax:
Practice Address - Street 1:5240 E GALBRAITH RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-2822
Practice Address - Country:US
Practice Address - Phone:513-312-5670
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-05
Last Update Date:2009-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.081160208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2333022Medicaid
OHG44403Medicare UPIN