| Cincinnati Advanced Medical Llc | |
|
9403 Kenwood Rd Ste D203 Blue Ash OH 45242-6878 | |
| (540) 908-5072 | |
| Not Available |
| Full Name | Cincinnati Advanced Medical Llc |
|---|---|
| Speciality | General Practice |
| Location | 9403 Kenwood Rd Ste D203, Blue Ash, Ohio |
| Authorized Official Name and Position | Jonathan Claar (OWNER, AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 5409085072 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cincinnati Advanced Medical Llc 9403 Kenwood Rd Ste D203 Blue Ash OH 45242-6878 Ph: (540) 908-5072 | Cincinnati Advanced Medical Llc 9403 Kenwood Rd Ste D203 Blue Ash OH 45242-6878 Ph: (540) 908-5072 |
| NPI Number | 1083234330 |
|---|---|
| Provider Enumeration Date | 04/16/2020 |
| Last Update Date | 04/16/2020 |
| Medicare PECOS PAC ID | 8123459799 |
|---|---|
| Medicare Enrollment ID | O20200702000904 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083234330 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Nicole Noble |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306301726 PECOS PAC ID: 9931433224 Enrollment ID: I20210115002178 |
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