1518104280 NPI number — HEART OF OHIO FAMILY HEALTH CENTERS

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 1518104280 NPI number — HEART OF OHIO FAMILY HEALTH CENTERS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEART OF OHIO FAMILY HEALTH CENTERS
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:
6
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:
1518104280
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/31/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 632127
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45263-2127
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-235-5555
Provider Business Mailing Address Fax Number:
614-536-1994

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5000 E MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43213-2440
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-235-5555
Provider Business Practice Location Address Fax Number:
614-338-6839
Provider Enumeration Date:
01/16/2009

Additional Information

Authorized Official

Authorized Official Last Name:
SANDMAND
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
B.
Authorized Official Title or Position:
ACTING CEO
Authorized Official Telephone Number:
614-338-6820

Provider Taxonomy Codes

  • Taxonomy code: 261QP2300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QF0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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