1679528574 NPI number — CENTRAL OHIO PATHOLOGY ASSOCIATES

Table of content: MS. KAREN MICHELLE CAPSHAW FNP (NPI 1275795676)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679528574 NPI number — CENTRAL OHIO PATHOLOGY ASSOCIATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTRAL OHIO PATHOLOGY ASSOCIATES
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:
1679528574
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 951427
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLEVELAND
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44193-0016
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
843-664-4300
Provider Business Mailing Address Fax Number:
843-664-4308

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
793 W STATE ST
Provider Second Line Business Practice Location Address:
MCW HOSPITAL PATHOLOGY DEPT
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43222-1551
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-234-5819
Provider Business Practice Location Address Fax Number:
614-234-2931
Provider Enumeration Date:
05/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
TAYLOR
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
C
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
614-234-1304

Provider Taxonomy Codes

  • Taxonomy code: 207ZP0102X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2549326 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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