Healthcare Provider Details

I. General information

NPI: 1215772058
Provider Name (Legal Business Name): COMPANION CARE COLUMBUS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2024
Last Update Date: 01/27/2025
Certification Date: 01/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1028 ARCARO DR
COLUMBUS OH
43230-3855
US

IV. Provider business mailing address

1028 ARCARO DR
COLUMBUS OH
43230-3855
US

V. Phone/Fax

Practice location:
  • Phone: 614-208-1022
  • Fax:
Mailing address:
  • Phone: 614-208-1022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: COURTNEY SIMMONS
Title or Position: MANAGING MEMBER
Credential:
Phone: 614-208-1022