Healthcare Provider Details
I. General information
NPI: 1447893284
Provider Name (Legal Business Name): COLUMBUS NEIGHBORHOOD HEALTH CENTER, INC. DBA PRIMARYONE HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/24/2019
Last Update Date: 10/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
730 W. TOWN STREET
COLUMBUS OH
43222
US
IV. Provider business mailing address
2780 AIRPORT DR STE 100
COLUMBUS OH
43219-2289
US
V. Phone/Fax
- Phone: 614-859-1906
- Fax: 614-645-5517
- Phone: 614-859-1906
- Fax: 614-645-5517
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BRIGID
L
EVERHART
Title or Position: COMPLIANCE MANAGER
Credential:
Phone: 614-645-5500