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General NPI Number Information
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NPI Number | 1588837728
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Entity Type | Organization
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Legal Business Name | POMEGRANATE HEALTH SYSTEMS OF CENTRAL OHIO, INC.
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Dates
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Enumeration Date | 04/09/2008
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Last Update Date | 08/28/2013
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Provider Practice Location Address
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Address Line | 765 PIERCE DR.
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City | COLUMBUS
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State | OH
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Zip | 43223
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Country | US
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Telephone | 614-223-1650
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Fax | 888-727-7834
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Provider Business Mailing Address
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Address Line | 65418 BARKCAMP PARK RD
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City | BELMONT
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State | OH
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Zip | 43718-9733
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Country | US
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Telephone | 740-782-1211
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Fax | 877-662-2747
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. CHINTA KASIRAJA
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Credential |
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Telephone | 304-281-7011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | 10-5476
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number | 10-2068
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License Number State | OH
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