Provider Demographics
NPI:1124018429
Name:COLUMBUS WEST HEALTH CARE CO.
Entity Type:Organization
Organization Name:COLUMBUS WEST HEALTH CARE CO.
Other - Org Name:COLUMBUS WEST PARK NURSING AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:STEWART
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:NHA, MHA
Authorized Official - Phone:614-274-4222
Mailing Address - Street 1:1700 HEINZERLING DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43223-3671
Mailing Address - Country:US
Mailing Address - Phone:614-274-4222
Mailing Address - Fax:614-275-3722
Practice Address - Street 1:1700 HEINZERLING DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43223-3671
Practice Address - Country:US
Practice Address - Phone:614-274-4222
Practice Address - Fax:614-275-3722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-27
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4207314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0565624Medicaid
OH0565624Medicaid