MEDICARE: COLUMBUS NEIGHBORHOOD HEALTH CENTER, INC.

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	261QP2300X	Primary Care Clinic/Center

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	3618781	OTHER	OH	MEDICARE #

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
3	36D0982502	OTHER	OH	CLIA

General Provider Information

NPI Number	:	1811050636
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLUMBUS NEIGHBORHOOD HEALTH CENTER, INC.

Provider Business Mailing Address
First Line	:	2780 AIRPORT DR STE 100
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43219-2289
Country	:	US
Telephone Number	:	614-645-5500
Fax Number	:	614-645-5517

Provider Business Practice Location Address
First Line	:	3433 AGLER RD
Second Line	:	SUITE 2800
City	:	COLUMBUS
State	:	OH
Zip	:	43219-3387
Country	:	US
Telephone Number	:	614-645-1600
Fax Number	:	614-645-1347

Authorized Official
Title or Position	:	COMPLIANCE MANAGER
Name	:	BRIGID L EVERHART
Credential	:
Telephone Number	:	614-645-5500

Provider Enumeration Date	:	12/19/2006
Last Update Date	:	08/30/2018

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Directions to “COLUMBUS NEIGHBORHOOD HEALTH CENTER, INC. ” Practice Location

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