1902149446 NPI number — ARCHANA CHAND D.O

Table of content: ARCHANA CHAND D.O (NPI 1902149446)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902149446 NPI number — ARCHANA CHAND D.O

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHAND
Provider First Name:
ARCHANA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
D.O
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BHATT
Provider Other First Name:
ARCHANA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
D.O
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1902149446
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/06/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
170 TAYLOR STATION RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLUMBUS
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43213-4491
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-545-7900
Provider Business Mailing Address Fax Number:
614-545-7901

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1087 DENNISON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43201-3201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
877-749-7428
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/03/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208100000X , with the licence number: 34.013081 , 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: 0306664 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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