Healthcare Provider Details

I. General information

NPI: 1578999553
Provider Name (Legal Business Name): CENTRAL OHIO SPECIALTY CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2013
Last Update Date: 02/08/2021
Certification Date: 02/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2349 WESTBROOKE DR BLDG A
COLUMBUS OH
43228-9557
US

IV. Provider business mailing address

2349 WESTBROOKE DR BLDG A
COLUMBUS OH
43228-9557
US

V. Phone/Fax

Practice location:
  • Phone: 614-790-0200
  • Fax: 614-754-5084
Mailing address:
  • Phone: 614-790-0200
  • Fax: 614-754-5084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberHMER.22969-JCHO
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: NICK KALOGERAS
Title or Position: VICE PRESIDENT
Credential:
Phone: 614-790-0200