MEDICARE: MEDICAL CONSULTANCY OF OHIO

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251E00000X	Home Health Agency
2	261Q00000X	Clinic/Center
3	261QA1903X	Ambulatory Surgical Clinic/Center
4	261QD1600X	Developmental Disabilities Clinic/Center
5	261QM1300X	Multi-Specialty Clinic/Center
6	261QM2500X	Medical Specialty Clinic/Center
7	261QP3300X	Pain Clinic/Center
8	261QR0400X	Rehabilitation Clinic/Center
9	343900000X	Non-emergency Medical Transport (VAN)
10	208100000X	Physical Medicine & Rehabilitation Physician

General Provider Information

NPI Number	:	1770200149
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL CONSULTANCY OF OHIO

Provider Business Mailing Address
First Line	:	PO BOX 1678
Second Line	:
City	:	POWELL
State	:	OH
Zip	:	43065-1678
Country	:	US
Telephone Number	:	330-888-2962
Fax Number	:

Provider Business Practice Location Address
First Line	:	1217 GRANDVIEW AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43212-3455
Country	:	US
Telephone Number	:	330-888-2962
Fax Number	:	330-280-5116

Authorized Official
Title or Position	:	CEO
Name	:	EDWIN CAPULONG
Credential	:	MD
Telephone Number	:	330-888-2962

Provider Enumeration Date	:	10/26/2022
Last Update Date	:	10/26/2022

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Directions to “MEDICAL CONSULTANCY OF OHIO ” Practice Location

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