MEDICARE: OSU JAMESCARE EAST HOSPSITAL

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	174400000X	Specialist	058949	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
2	TAX ID NUMBER	OTHER	OH	TAX ID #

General Provider Information

NPI Number	:	1922034578
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OSU JAMESCARE EAST HOSPSITAL

Provider Business Mailing Address
First Line	:	4199 HAYMAKER LN
Second Line	:
City	:	DUBLIN
State	:	OH
Zip	:	43017-1568
Country	:	US
Telephone Number	:	614-766-2397
Fax Number	:

Provider Business Practice Location Address
First Line	:	1492 E BROAD ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43205-1546
Country	:	US
Telephone Number	:	614-257-2900
Fax Number	:

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. AHMED M GHANY
Credential	:
Telephone Number	:	614-257-2900

Provider Enumeration Date	:	06/24/2006
Last Update Date	:	08/22/2020

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Directions to “OSU JAMESCARE EAST HOSPSITAL ” Practice Location

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