Basic Information
| Provider Information | |||||||||
| NPI: | 1508850926 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | AMERIMED, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6281 TRI RIDGE BLVD STE 300 | ||||||||
| Address2: | |||||||||
| City: | LOVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 451408345 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5135760262 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9961 CINCINNATI DAYTON RD | ||||||||
| Address2: | |||||||||
| City: | WEST CHESTER | ||||||||
| State: | OH | ||||||||
| PostalCode: | 450693823 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5139423670 | ||||||||
| FaxNumber: | 5139422846 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2005 | ||||||||
| LastUpdateDate: | 07/20/2022 | ||||||||
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| AuthorizedOfficialLastName: | HAWKINS | ||||||||
| AuthorizedOfficialFirstName: | JACK | ||||||||
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| AuthorizedOfficialTitleorPosition: | VP, FINANCE/CFO | ||||||||
| AuthorizedOfficialTelephone: | 5135768478 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 07/20/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 3336H0001X | N | Suppliers | Pharmacy | Home Infusion Therapy Pharmacy | 251F00000X | OH | Y | Agencies | Home Infusion |
ID Information
| ID | Type | State | Issuer | Description | 0800502 | 05 | OH | MEDICAID | 54024690 | 05 | KY | MEDICAID | 90254095 | 05 | KY | MEDICAID | 100018880 | 05 | IN | MEDICAID | 45904323 | 05 | KY | MEDICAID |