1275580003 NPI number — COLUMBUS HOSPITAL, LLC

Table of content: (NPI 1275580003)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275580003 NPI number — COLUMBUS HOSPITAL, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COLUMBUS HOSPITAL, 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:
COLUMBUS BEHAVIORAL CENTER FOR CHILDREN AND ADOLESCENTS
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:
1275580003
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/28/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 287
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENWOOD
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46142-0287
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
317-887-1348
Provider Business Mailing Address Fax Number:
317-885-9063

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2223 POSHARD RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47203-1844
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-376-1771
Provider Business Practice Location Address Fax Number:
317-885-9063
Provider Enumeration Date:
05/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
FILTON
Authorized Official First Name:
STEVE
Authorized Official Middle Name:
Authorized Official Title or Position:
SR VP CFO
Authorized Official Telephone Number:
610-678-3300

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 323P00000X , with the licence number: 73722 , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 323P00000X , with the licence number: 73742 , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 323P00000X , with the licence number: 33567 , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 323P00000X , with the licence number: 73779 , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 200151640A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200492270A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 201049280A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".




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