1568975795 NPI number — UNIFIED HEALTH & WELLNESS

Table of content: (NPI 1568975795)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568975795 NPI number — UNIFIED HEALTH & WELLNESS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIFIED HEALTH & WELLNESS
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:
6
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:
1568975795
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7243 SAWMILL RD STE 105
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DUBLIN
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43016-5005
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-389-3814
Provider Business Mailing Address Fax Number:
514-389-3841

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7243 SAWMILL RD STE 105
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DUBLIN
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43016-5005
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-389-3814
Provider Business Practice Location Address Fax Number:
614-389-3841
Provider Enumeration Date:
11/09/2017

Additional Information

Authorized Official

Authorized Official Last Name:
MEYER
Authorized Official First Name:
MICHELLE
Authorized Official Middle Name:
M
Authorized Official Title or Position:
OWNER/PROVIDER
Authorized Official Telephone Number:
614-389-3814

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: F0514404 . This is a "AANC BOARD CERTIFICATION - FAMILY NURSE PRACTITIONER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0257860 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0104001 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: APRN.CNP.15910 . This is a "LICENSE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 2013008374 . This is a "ANCC BOARD CERTIFICATION ADULT PSYCH MENTAL HEALTH NURSE PRACTITIONER" identifier . This identifiers is of the category "OTHER".




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