Healthcare Provider Details

I. General information

NPI: 1215091343
Provider Name (Legal Business Name): COLUMBUS MEDICAL EQUIPMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 04/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 E 5TH AVE
COLUMBUS OH
43201-2820
US

IV. Provider business mailing address

306 E 5TH AVE
COLUMBUS OH
43201-2820
US

V. Phone/Fax

Practice location:
  • Phone: 614-294-5585
  • Fax:
Mailing address:
  • Phone: 614-294-5585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number25-249582
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number25-249582
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number25-249582
License Number StateOH

VIII. Authorized Official

Name: MR. CARL A. MULBERRY
Title or Position: PRESIDENT
Credential:
Phone: 614-294-5585