Provider Demographics
NPI:1093201246
Name:CENTRAL OHIO NEPHROLOGY AND HYPERTENSION CLINIC LLC
Entity Type:Organization
Organization Name:CENTRAL OHIO NEPHROLOGY AND HYPERTENSION CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:MURITHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-745-9468
Mailing Address - Street 1:691 SOUTHBLUFF DR
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-8605
Mailing Address - Country:US
Mailing Address - Phone:614-423-8506
Mailing Address - Fax:
Practice Address - Street 1:550 S CLEVELAND AVE STE A
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-8958
Practice Address - Country:US
Practice Address - Phone:614-745-9468
Practice Address - Fax:877-538-7923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-10
Last Update Date:2020-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH201815201106261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty