Healthcare Provider Details

I. General information

NPI: 1619103116
Provider Name (Legal Business Name): ERNEST MENSAH OPUNI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2009
Last Update Date: 06/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 MORSE RD STE 307
COLUMBUS OH
43229-6327
US

IV. Provider business mailing address

1150 MORSE RD STE 307
COLUMBUS OH
43229-6327
US

V. Phone/Fax

Practice location:
  • Phone: 614-270-0448
  • Fax: 877-777-6890
Mailing address:
  • Phone: 614-270-0448
  • Fax: 877-777-6890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License NumberTH763978
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License NumberTH763978
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License NumberTH763978
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: