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NPI Code Detail

MEDICARE: COLUMBUS FAMILY CARE CENTER LLC

MEDICARE: COLUMBUS FAMILY CARE CENTER LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1285391698
Entity Type Code : Organization
Provider Name (Legal Business Name) : COLUMBUS FAMILY CARE CENTER LLC
Provider Business Mailing Address
First Line : 2800 W BROAD ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43204-2654
Country : US
Telephone Number : 614-274-4171
Fax Number :
Provider Business Practice Location Address
First Line : 2800 W BROAD ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43204-2654
Country : US
Telephone Number : 614-274-4171
Fax Number :
Authorized Official
Title or Position : CEO
Name : JACOBINA ASUNSULEY ADAMU
Credential : FNP
Telephone Number : 614-274-4171
Provider Enumeration Date : 11/19/2021
Last Update Date : 10/17/2024

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Directions to “COLUMBUS FAMILY CARE CENTER LLC ” Practice Location

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