1457442279 NPI number — COLUMBUS SENIORS INC

Table of content: (NPI 1457442279)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457442279 NPI number — COLUMBUS SENIORS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COLUMBUS SENIORS 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:
Provider Other Organization Name Type Code:
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:
1457442279
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:
52 WESTERVILLE SQ
Provider Second Line Business Mailing Address:
#143
Provider Business Mailing Address City Name:
WESTERVILLE
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43081-2919
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-890-4983
Provider Business Mailing Address Fax Number:
614-890-4355

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
575 COPELAND MILL RD
Provider Second Line Business Practice Location Address:
SUITE 1F
Provider Business Practice Location Address City Name:
WESTERVILLE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43081-8977
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-890-4983
Provider Business Practice Location Address Fax Number:
614-890-4355
Provider Enumeration Date:
09/27/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
REISING
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
800-836-2904

Provider Taxonomy Codes

  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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