Healthcare Provider Details

I. General information

NPI: 1194760439
Provider Name (Legal Business Name): CITY OF COLUMBUS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2006
Last Update Date: 06/24/2015
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: 614-645-6792
  • Fax: 614-645-6091
Mailing address:
  • Phone: 614-645-6793
  • Fax: 614-645-6091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number StateOH

VIII. Authorized Official

Name: DR. TERESA C. LONG
Title or Position: HEALTH COMMISSIONER
Credential: M.D., M.P.H.
Phone: 614-645-7417