Provider Demographics
NPI:1730190976
Name:UNIVERSITY OF CINCINNATI MEDICAL CENTER LLC
Entity type:Organization
Organization Name:UNIVERSITY OF CINCINNATI MEDICAL CENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT DIRECTOR PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:LOBAS
Authorized Official - Suffix:
Authorized Official - Credentials:MS,RPH
Authorized Official - Phone:513-584-8807
Mailing Address - Street 1:EDEN AND ALBERT SABIN WAY
Mailing Address - Street 2:MAIL LOCATION 0443
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219
Mailing Address - Country:US
Mailing Address - Phone:513-584-8820
Mailing Address - Fax:513-584-5034
Practice Address - Street 1:EDEN AND ALBERT SABIN WAY
Practice Address - Street 2:MAIL LOCATION 0443
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219
Practice Address - Country:US
Practice Address - Phone:513-584-8820
Practice Address - Fax:513-584-5034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
OHCLPH.020994650-033336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2074549OtherPK
OH2141846Medicaid