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General NPI Number Information
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NPI Number | 1134930142
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Entity Type | Organization
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Legal Business Name | ZA-LA
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Dates
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Enumeration Date | 01/17/2025
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 2339 CLEVELAND AVE
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City | COLUMBUS
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State | OH
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Zip | 43211-1609
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Country | US
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Telephone | 614-400-1234
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Fax |
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Provider Business Mailing Address
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Address Line | 4105 BLUE COAT LN
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City | COLUMBUS
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State | OH
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Zip | 43230-1538
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Country | US
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Telephone | 614-400-1234
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Fax |
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Authorized Official
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Title or Position | APRN
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Name | MADONNA HILL
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Credential | APRN
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Telephone | 614-400-1234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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