1639148638 NPI number — STATE OF OHIO OFFICE OF BUDGET AND MANAGEMENT, STATE ACCOUNTING

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 1639148638 NPI number — STATE OF OHIO OFFICE OF BUDGET AND MANAGEMENT, STATE ACCOUNTING

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STATE OF OHIO OFFICE OF BUDGET AND MANAGEMENT, STATE ACCOUNTING
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:
CSN FISCAL REIMBURSEMENT
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:
1639148638
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/14/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
30 E. BROAD ST
Provider Second Line Business Mailing Address:
11TH FLOOR - FISCAL ADMINISTRATION
Provider Business Mailing Address City Name:
COLUMBUS
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43215-3430
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-466-6583
Provider Business Mailing Address Fax Number:
614-644-5331

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
30 E. BROAD ST
Provider Second Line Business Practice Location Address:
11TH FLOOR - FISCAL ADMINISTRATION
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43215-3430
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-466-6583
Provider Business Practice Location Address Fax Number:
614-644-5331
Provider Enumeration Date:
03/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
FASONE
Authorized Official First Name:
TONYA
Authorized Official Middle Name:
Authorized Official Title or Position:
REIMBURSEMENT MANAGER
Authorized Official Telephone Number:
614-466-6583

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 03275 . This is a "MACSIS VENDOR NUMBER" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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