1164477923 NPI number — CENTRAL OHIO PATHOLOGY ASSOCIATES

Table of content: (NPI 1164477923)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164477923 NPI number — CENTRAL OHIO PATHOLOGY ASSOCIATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTRAL OHIO PATHOLOGY ASSOCIATES
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:
1164477923
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/10/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 951427
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLEVELAND
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44193-0016
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-457-8180
Provider Business Mailing Address Fax Number:
614-583-3300

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
793 W STATE ST
Provider Second Line Business Practice Location Address:
MT. CARMEL W PATHOLOGY DEPT
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43222-1551
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-442-2400
Provider Business Practice Location Address Fax Number:
614-442-2403
Provider Enumeration Date:
05/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
TAYLOR
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
C
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
614-898-4454

Provider Taxonomy Codes

  • Taxonomy code: 207ZP0102X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2549326 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com