Healthcare Provider Details

I. General information

NPI: 1881758647
Provider Name (Legal Business Name): COLUMBUS NEIGHBORHOOD HEALTH CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 08/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 PARSONS AVE
COLUMBUS OH
43215
US

IV. Provider business mailing address

2780 AIRPORT DR STE 100
COLUMBUS OH
43219-2289
US

V. Phone/Fax

Practice location:
  • Phone: 614-645-7487
  • Fax: 614-645-7080
Mailing address:
  • Phone: 614-859-1906
  • Fax: 614-645-5517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BRIGID L EVERHART
Title or Position: COMPLIANCE MANAGER
Credential:
Phone: 614-645-5500