1316083470 NPI number — HEALTH FROM WITHIN, 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 1316083470 NPI number — HEALTH FROM WITHIN, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALTH FROM WITHIN, 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:
HEALTH FROM WITHIN
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:
1316083470
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7239 SAWMILL RD
Provider Second Line Business Mailing Address:
ST. 110
Provider Business Mailing Address City Name:
DUBLIN
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43016
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-761-3979
Provider Business Mailing Address Fax Number:
614-761-9993

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7239 SAWMILL RD
Provider Second Line Business Practice Location Address:
ST. 110
Provider Business Practice Location Address City Name:
DUBLIN
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43016
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-761-3979
Provider Business Practice Location Address Fax Number:
614-761-9993
Provider Enumeration Date:
01/29/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SCHROEDER
Authorized Official First Name:
DEBRA
Authorized Official Middle Name:
SUE
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
614-761-3979

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000000344483 . This is a "ANTHEM" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 283760212002 . This is a "MEDICAL MUTUAL" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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