MEDICARE: COLUMBUS MEDICAL SERVICES

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
1	251B00000X	Case Management Agency

Other Identifiers

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

General Provider Information

NPI Number	:	1366687592
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLUMBUS MEDICAL SERVICES

Provider Business Mailing Address
First Line	:	2250 CORPORATE PLAZA PKWY SE
Second Line	:	SUITE 202
City	:	SMYRNA
State	:	GA
Zip	:	30080-2969
Country	:	US
Telephone Number	:	770-916-1091
Fax Number	:	770-916-1120

Provider Business Practice Location Address
First Line	:	138 CANAL ST
Second Line	:	UNTI 507
City	:	POOLER
State	:	GA
Zip	:	31322-4051
Country	:	US
Telephone Number	:	912-748-0580
Fax Number	:	912-748-1333

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	SARA WATSON
Credential	:
Telephone Number	:	770-916-1091

Provider Enumeration Date	:	12/02/2008
Last Update Date	:	12/02/2008

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Directions to “COLUMBUS MEDICAL SERVICES ” Practice Location

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