1154698256 NPI number — OHIO GASTROENTEROLOGY AND RHEUMATOLOGY SOLUTIONS CENTER

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154698256 NPI number — OHIO GASTROENTEROLOGY AND RHEUMATOLOGY SOLUTIONS CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OHIO GASTROENTEROLOGY AND RHEUMATOLOGY SOLUTIONS CENTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1154698256
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/18/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
387 COUNTY LINE RD W
Provider Second Line Business Mailing Address:
STE 225
Provider Business Mailing Address City Name:
WESTERVILLE
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43082-6080
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-776-5541
Provider Business Mailing Address Fax Number:
614-776-5561

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
387 COUNTY LINE RD W
Provider Second Line Business Practice Location Address:
STE 225
Provider Business Practice Location Address City Name:
WESTERVILLE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43082-6080
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-776-5541
Provider Business Practice Location Address Fax Number:
614-776-5561
Provider Enumeration Date:
11/18/2011

Additional Information

Authorized Official

Authorized Official Last Name:
SAYMEH
Authorized Official First Name:
LAYTH
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
315-877-4106

Provider Taxonomy Codes

  • Taxonomy code: 207RR0500X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RG0100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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