Healthcare Provider Details

I. General information

NPI: 1669535373
Provider Name (Legal Business Name): COLUMBUS NEIGHBORHOOD HEALTH CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 PARSONS AVE SUITE 233
COLUMBUS OH
43215-4331
US

IV. Provider business mailing address

3433 AGLER RD STE 2800
COLUMBUS OH
43219-3389
US

V. Phone/Fax

Practice location:
  • Phone: 614-645-7487
  • Fax: 614-645-7080
Mailing address:
  • Phone: 614-859-1906
  • Fax: 614-458-1849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: JOHNETTA RIDGEWAY
Title or Position: PROVIDER ENROLLMENT COORDINATOR
Credential:
Phone: 614-859-1906