Healthcare Provider Details

I. General information

NPI: 1053215913
Provider Name (Legal Business Name): ALTA HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3887 INDIANOLA AVE STE A
COLUMBUS OH
43214-3201
US

IV. Provider business mailing address

3887 INDIANOLA AVE STE A
COLUMBUS OH
43214-3201
US

V. Phone/Fax

Practice location:
  • Phone: 614-547-2050
  • Fax: 614-612-0580
Mailing address:
  • Phone: 614-547-2050
  • Fax: 614-612-0580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: ERIC RYAN DARDINGER
Title or Position: NURSE PRACTITIONER
Credential: APRN
Phone: 614-547-2020