Healthcare Provider Details

I. General information

NPI: 1114387800
Provider Name (Legal Business Name): OFFOR HEALTH, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2016
Last Update Date: 04/26/2022
Certification Date: 04/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1103 SCHROCK RD STE 201
COLUMBUS OH
43229-1179
US

IV. Provider business mailing address

1103 SCHROCK RD STE 201
COLUMBUS OH
43229-1179
US

V. Phone/Fax

Practice location:
  • Phone: 614-401-4415
  • Fax:
Mailing address:
  • Phone: 614-401-4415
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223D0004X
TaxonomyDental Anesthesiology
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: VASKEYSA COOLEY
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 614-401-4415