Provider Demographics
NPI:1073899985
Name:OLUBUMI J JONES
Entity Type:Organization
Organization Name:OLUBUMI J JONES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/C.E.O
Authorized Official - Prefix:MR
Authorized Official - First Name:OLUBUMI
Authorized Official - Middle Name:JEFFEREY
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-937-9131
Mailing Address - Street 1:3391 OMEGA DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-8833
Mailing Address - Country:US
Mailing Address - Phone:614-937-9131
Mailing Address - Fax:
Practice Address - Street 1:3391 OMEGA DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-8833
Practice Address - Country:US
Practice Address - Phone:614-937-9131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-25
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH201030700377251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3063750Medicaid