MEDICARE: WOODLANDS AT EASTLAND

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility	2072R	OH

General Provider Information

NPI Number	:	1053444661
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOODLANDS AT EASTLAND

Provider Business Mailing Address
First Line	:	2469 KIMBERLY PKWY E
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43232-4273
Country	:	US
Telephone Number	:	614-866-2080
Fax Number	:	614-866-8552

Provider Business Practice Location Address
First Line	:	2469 KIMBERLY PKWY E
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43232-4273
Country	:	US
Telephone Number	:	614-866-2080
Fax Number	:	614-866-8552

Authorized Official
Title or Position	:	DIRECTOR
Name	:	TARA BURNS
Credential	:
Telephone Number	:	614-866-2080

Provider Enumeration Date	:	03/13/2007
Last Update Date	:	08/22/2020

Similar Medicare Providers

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Practice Location Address:

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1033071634 — JAYVAUGHN RANDLE-DUMAS
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1538017611 — SHIAIRE LANE
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1033484126 — MELISSA SWANSON
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Directions to “WOODLANDS AT EASTLAND ” Practice Location

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