1841649092 NPI number — OHIOHEALTH GENETIC COUNSELING

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 1841649092 NPI number — OHIOHEALTH GENETIC COUNSELING

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OHIOHEALTH GENETIC COUNSELING
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:
1841649092
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/26/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
500 THOMAS LN
Provider Second Line Business Mailing Address:
STE 2D
Provider Business Mailing Address City Name:
COLUMBUS
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43214-1401
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-788-4640
Provider Business Mailing Address Fax Number:
614-788-4650

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
500 THOMAS LN
Provider Second Line Business Practice Location Address:
STE 2D
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43214-1401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-788-4640
Provider Business Practice Location Address Fax Number:
614-788-4650
Provider Enumeration Date:
06/08/2016

Additional Information

Authorized Official

Authorized Official Last Name:
MORMAN
Authorized Official First Name:
NICHOLE
Authorized Official Middle Name:
A.
Authorized Official Title or Position:
LICENSED GENETIC COUNSELOR
Authorized Official Telephone Number:
614-788-4642

Provider Taxonomy Codes

  • Taxonomy code: 261QG0250X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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