Healthcare Provider Details

I. General information

NPI: 1083877211
Provider Name (Legal Business Name): COLUMBUS AREA COMMUNITY MENTAL HEALTH CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2008
Last Update Date: 10/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 E BROAD ST
COLUMBUS OH
43205-1550
US

IV. Provider business mailing address

1515 E BROAD ST
COLUMBUS OH
43205-1550
US

V. Phone/Fax

Practice location:
  • Phone: 614-252-0711
  • Fax: 614-252-9250
Mailing address:
  • Phone: 614-252-0711
  • Fax: 614-252-9250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number021765550
License Number StateOH

VIII. Authorized Official

Name: ABASHAMO LENCHO
Title or Position: PHARMACY MANAGER
Credential:
Phone: 614-251-7791