MEDICARE: GAHANNA HEALTH CARE 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	314000000X	Skilled Nursing Facility	1730N	OH
2	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)	1730	OH

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	:	1184626285
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GAHANNA HEALTH CARE CENTER, INC.

Provider Business Mailing Address
First Line	:	22021 BROOKPARK RD
Second Line	:	STE 123
City	:	FAIRVIEW PARK
State	:	OH
Zip	:	44126-3100
Country	:	US
Telephone Number	:	440-614-0160
Fax Number	:	440-614-0168

Provider Business Practice Location Address
First Line	:	121 JAMES RD
Second Line	:
City	:	GAHANNA
State	:	OH
Zip	:	43230-2825
Country	:	US
Telephone Number	:	614-475-7222
Fax Number	:	614-475-2982

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BRIAN COLLERAN
Credential	:
Telephone Number	:	440-614-0160

Provider Enumeration Date	:	06/02/2005
Last Update Date	:	09/11/2025

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