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General NPI Number Information
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NPI Number | 1821202870
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Entity Type | Organization
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Legal Business Name | CONCHITALOPEZ
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 08/08/2008
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Provider Practice Location Address
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Address Line | 3122 SCOTTWOOD RD
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City | COLUMBUS
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State | OH
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Zip | 43227-3446
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Country | US
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Telephone | 614-235-3581
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Fax |
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Provider Business Mailing Address
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Address Line | 3122 SCOTTWOOD RD
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City | COLUMBUS
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State | OH
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Zip | 43227-3446
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Country | US
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Telephone | 614-235-3581
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Fax |
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Authorized Official
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Title or Position | I.P.
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Name | MS. CONCHITA ELEENA LOPEZ
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Credential |
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Telephone | 614-235-3581
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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