1669897757 NPI number — GOOD NIGHT MEDICAL OF OHIO, LLC

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 1669897757 NPI number — GOOD NIGHT MEDICAL OF OHIO, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GOOD NIGHT MEDICAL OF OHIO, LLC
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:
GOOD NIGHT MEDICAL
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:
1669897757
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/27/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8999 GEMINI PKWY STE 220
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:
43240-2249
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-384-7433
Provider Business Mailing Address Fax Number:
614-386-0278

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
220 SWANTON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WINCHESTER
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01890
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-396-3683
Provider Business Practice Location Address Fax Number:
614-386-0278
Provider Enumeration Date:
02/26/2014

Additional Information

Authorized Official

Authorized Official Last Name:
CRAWFORD
Authorized Official First Name:
GREGORY
Authorized Official Middle Name:
J
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
859-441-8876

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332BX2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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