Healthcare Provider Details

I. General information

NPI: 1588285712
Provider Name (Legal Business Name): SPRINGWAY MEDICAL AND ADDICTION TREATMENT CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2020
Last Update Date: 04/04/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4770 INDIANOLA AVE STE 201
COLUMBUS OH
43214-1876
US

IV. Provider business mailing address

4770 INDIANOLA AVE STE 201
COLUMBUS OH
43214-1876
US

V. Phone/Fax

Practice location:
  • Phone: 614-725-6035
  • Fax: 614-987-6108
Mailing address:
  • Phone: 614-725-6035
  • Fax: 614-987-6108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: AKWASI AGYEMANG
Title or Position: OWNER
Credential: FNP
Phone: 614-725-6035