Healthcare Provider Details

I. General information

NPI: 1720228877
Provider Name (Legal Business Name): CITY OF COLUMBUS - COLUMBUS HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2009
Last Update Date: 03/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 PARSONS AVE
COLUMBUS OH
43215-5331
US

IV. Provider business mailing address

240 PARSONS AVE
COLUMBUS OH
43215-5331
US

V. Phone/Fax

Practice location:
  • Phone: 614-645-6447
  • Fax:
Mailing address:
  • Phone: 614-645-6447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP0905X
TaxonomyState or Local Public Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. TERESA C. LONG
Title or Position: HEALTH COMMISSIONER
Credential: M.D., M.P.H
Phone: 614-645-6447