1538569827 NPI number — COLUMBUS NEIGHBORHOOD HEALTH CENTER, INC.

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 1538569827 NPI number — COLUMBUS NEIGHBORHOOD HEALTH CENTER, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COLUMBUS NEIGHBORHOOD HEALTH CENTER, INC.
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:
PRIMARYONE HEALTH
Provider Other Organization Name Type Code:
3
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:
1538569827
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/12/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2780 AIRPORT DR STE 100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLUMBUS
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43219-2289
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-645-5500
Provider Business Mailing Address Fax Number:
614-645-5517

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4661 SAWMILL RD STE 101
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:
43220-6123
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-526-3285
Provider Business Practice Location Address Fax Number:
614-645-5517
Provider Enumeration Date:
08/25/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
EVERHART
Authorized Official First Name:
BRIGID
Authorized Official Middle Name:
L
Authorized Official Title or Position:
COMPLIANCE MANAGER
Authorized Official Telephone Number:
614-645-5500

Provider Taxonomy Codes

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

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

  • Identifier: 36D2082375 . This is a "CLIA" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 361064 . This is a "CMS CERTIFICATION NUMBER (CCN)" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 121809 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".