Healthcare Provider Details

I. General information

NPI: 1124154745
Provider Name (Legal Business Name): SURGEONS CHOICE FIRST ASSISTING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 12/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

893 MENDES CT
COLUMBUS OH
43235-3506
US

IV. Provider business mailing address

893 MENDES CT
COLUMBUS OH
43235-3506
US

V. Phone/Fax

Practice location:
  • Phone: 614-824-5200
  • Fax: 888-329-6432
Mailing address:
  • Phone: 614-824-5200
  • Fax: 888-329-6432

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License NumberRN.231212
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number
License Number StateOH

VIII. Authorized Official

Name: KATHLEEN DIEDALIS
Title or Position: PRESIDENT
Credential: CST/CSFA
Phone: 614-824-5200