Provider Demographics
NPI:1023219722
Name:SIMPLY EZ OF COLUMBUS LTD
Entity Type:Organization
Organization Name:SIMPLY EZ OF COLUMBUS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STATUTORY AGENT MEMBER MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SAVOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-308-1844
Mailing Address - Street 1:3593 INTERCHANGE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43204-1400
Mailing Address - Country:US
Mailing Address - Phone:614-308-1844
Mailing Address - Fax:614-278-9728
Practice Address - Street 1:3593 INTERCHANGE RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43204-1400
Practice Address - Country:US
Practice Address - Phone:614-308-1844
Practice Address - Fax:614-278-9728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH332U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2637678Medicaid