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General NPI Number Information
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NPI Number | 1932868114
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Entity Type | Organization
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Legal Business Name | COMMUNITY MEDICAL CENTER
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Dates
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Enumeration Date | 12/15/2021
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Last Update Date | 12/15/2021
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Provider Practice Location Address
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Address Line | 1380 DUBLIN RD
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City | COLUMBUS
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State | OH
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Zip | 43215-1025
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Country | US
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Telephone | 614-788-7117
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Fax | 614-788-7118
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Provider Business Mailing Address
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Address Line | 144 CRABAPPLE LN
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City | ETNA
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State | OH
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Zip | 43062-7074
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Country | US
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Telephone | 740-644-1293
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Fax |
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Authorized Official
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Title or Position | RN
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Name | MRS. PAMELA TINA PAYETTE
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Credential | BSN, RN
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Telephone | 740-644-1293
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Registered Nurse
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License Number |
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License Number State |
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