MEDICARE: HEALTHCARE VENTURES OF OHIO, LLC

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	1946N	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	:	1376616110
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHCARE VENTURES OF OHIO, LLC

Provider Business Mailing Address
First Line	:	1661 OLD HENDERSON RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43220-3644
Country	:	US
Telephone Number	:	614-459-2482
Fax Number	:	614-459-2641

Provider Business Practice Location Address
First Line	:	700 JASONWAY AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43214-2458
Country	:	US
Telephone Number	:	614-459-7050
Fax Number	:	614-459-2338

Authorized Official
Title or Position	:	CONTROLLER
Name	:	OSCAR G ALEMAN
Credential	:
Telephone Number	:	614-459-2482

Provider Enumeration Date	:	11/17/2006
Last Update Date	:	08/16/2017

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