MEDICARE: SPRINGWAY MEDICAL AND ADDICTION TREATMENT CENTER

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	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1548155617
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPRINGWAY MEDICAL AND ADDICTION TREATMENT CENTER

Provider Business Mailing Address
First Line	:	1969 E DUBLIN GRANVILLE RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43229-3508
Country	:	US
Telephone Number	:	614-987-6103
Fax Number	:

Provider Business Practice Location Address
First Line	:	4770 INDIANOLA AVE STE 201
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43214-1876
Country	:	US
Telephone Number	:	614-987-6103
Fax Number	:

Authorized Official
Title or Position	:	PRACTICE OWNER
Name	:	AKWASI AGYEMANG
Credential	:
Telephone Number	:	614-725-6035

Provider Enumeration Date	:	06/10/2025
Last Update Date	:	10/28/2025

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