1952826737 NPI number — MRS. HILARY SCHADLE DEMOSTENES LSW

Table of content: MRS. HILARY SCHADLE DEMOSTENES LSW (NPI 1952826737)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952826737 NPI number — MRS. HILARY SCHADLE DEMOSTENES LSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DEMOSTENES
Provider First Name:
HILARY
Provider Middle Name:
SCHADLE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SMITH
Provider Other First Name:
HILARY
Provider Other Middle Name:
SCHADLE
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1952826737
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2780 AIRPORT DRIVE, SUITE 100
Provider Second Line Business Mailing Address:
SUITE 100 - BILLING/CREDENTIALING DEPT.
Provider Business Mailing Address City Name:
COLUMBUS
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43229-2289
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-645-5500
Provider Business Mailing Address Fax Number:
614-645-5517

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2780 AIRPORT DR
Provider Second Line Business Practice Location Address:
SUITE 100 - BILLING/CREDENTIALING DEPT.
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43219
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-645-5500
Provider Business Practice Location Address Fax Number:
614-645-5517
Provider Enumeration Date:
08/14/2017

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: 1041C0700X , with the licence number:  1700707 , 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)





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