Basic Information
| Provider Information | |||||||||
| NPI: | 1821718016 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WINTON HILLS MEDICAL AND HEALTH CENTER, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1019 LINN ST | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452031314 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5132337100 | ||||||||
| FaxNumber: | 5132421760 | ||||||||
| Practice Location | |||||||||
| Address1: | 5275 WINNESTE AVE | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452321130 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5132337100 | ||||||||
| FaxNumber: | 5132421539 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2022 | ||||||||
| LastUpdateDate: | 08/30/2022 | ||||||||
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| AuthorizedOfficialLastName: | TUDOR | ||||||||
| AuthorizedOfficialFirstName: | RUTHETTA | ||||||||
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| AuthorizedOfficialTitleorPosition: | COO | ||||||||
| AuthorizedOfficialTelephone: | 5132337100 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 08/30/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 3336C0003X | Y | Suppliers | Pharmacy | Community/Retail Pharmacy |
ID Information
| ID | Type | State | Issuer | Description | 0232000331 | 01 | OH | OHIO STATE BOARD OF PHARMACY | OTHER |