LIBERTY FOREST FAIR LLC NPI 1578922936

NPI Information

  • NPI: 1578922936
  • Provider Name: LIBERTY FOREST FAIR, LLC
  • Classification: Clinic/Center - 261QE0700X
  • Specialization: End-Stage Renal Disease (ESRD) Treatment
  • Entity Type: Organization
  • Doing Business As: LIBERTY FOREST FAIR
  • CLIA Number: 36D2109386
  • Address: 1198 W KEMPER RD
    CINCINNATI, OH
    ZIP 45240
  • Phone: (513) 648-9175

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NPI Details

LIBERTY FOREST FAIR, LLC is an end-stage renal disease (esrd) treatment clinic center in Cincinnati, OH. LIBERTY FOREST FAIR, LLC NPI is 1578922936. The provider is registered as an organization entity type.
The provider Is Doing Business As Liberty Forest Fair.

The provider's business location address is:

1198 W KEMPER RD
CINCINNATI, OH
ZIP 45240-708
Phone: (513) 648-9175
Fax: (513) 648-9540

The provider's authorized official is Barry L. Blanton .
The authorized official title is Vice President and has the following contact phone number (781) 699-9000.

The CLIA number assigned to this NPI record is 36D2109386 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/15/2016 and was last updated on 10/19/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QE0700XClinic/CenterEnd-Stage Renal Disease (ESRD) TreatmentYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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