Healthcare Provider Details

I. General information

NPI: 1841806577
Provider Name (Legal Business Name): ANITA PREMPEH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2020
Last Update Date: 09/17/2020
Certification Date: 09/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

775 W BROAD ST STE 210
COLUMBUS OH
43222-1471
US

IV. Provider business mailing address

775 W BROAD ST STE 210
COLUMBUS OH
43222-1471
US

V. Phone/Fax

Practice location:
  • Phone: 614-471-1771
  • Fax:
Mailing address:
  • Phone: 614-471-1771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247000000X
TaxonomyHealth Information Technician
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: