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NPI Code Detail

MEDICARE: ZA-LA

MEDICARE: ZA-LA
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
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1134930142
Entity Type Code : Organization
Provider Name (Legal Business Name) : ZA-LA
Provider Business Mailing Address
First Line : 4105 BLUE COAT LN
Second Line :
City : COLUMBUS
State : OH
Zip : 43230-1538
Country : US
Telephone Number : 614-400-1234
Fax Number :
Provider Business Practice Location Address
First Line : 2339 CLEVELAND AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43211-1609
Country : US
Telephone Number : 614-400-1234
Fax Number :
Authorized Official
Title or Position : APRN
Name : MADONNA HILL
Credential : APRN
Telephone Number : 614-400-1234
Provider Enumeration Date : 01/17/2025
Last Update Date : 01/17/2025

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Directions to “ZA-LA ” Practice Location

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