MEDICARE: LOWER LIGHTS CHRISTIAN HEALTH CENTER, INC.

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	261QF0400X	Federally Qualified Health Center (FQHC)
2	261QP2300X	Primary Care Clinic/Center		OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	9319022	OTHER	OH	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154630408
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOWER LIGHTS CHRISTIAN HEALTH CENTER, INC.

Provider Business Mailing Address
First Line	:	1160 W BROAD ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43222-1352
Country	:	US
Telephone Number	:	614-274-1455
Fax Number	:	614-274-1433

Provider Business Practice Location Address
First Line	:	777 W STATE ST
Second Line	:	SUITE 201
City	:	COLUMBUS
State	:	OH
Zip	:	43222-1536
Country	:	US
Telephone Number	:	614-274-1455
Fax Number	:	614-274-1433

Authorized Official
Title or Position	:	BILLING DIRECTOR
Name	:	MICHELLE ARMSTRONG
Credential	:
Telephone Number	:	614-274-1455

Provider Enumeration Date	:	10/05/2010
Last Update Date	:	03/11/2022

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Directions to “LOWER LIGHTS CHRISTIAN HEALTH CENTER, INC. ” Practice Location

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