Provider Demographics
NPI:1164731568
Name:R.F. HENN & M.C. GALLAGHER, M.D.'S, INC.
Entity Type:Organization
Organization Name:R.F. HENN & M.C. GALLAGHER, M.D.'S, INC.
Other - Org Name:MARJORIE GALLAGHER, M.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARJORIE
Authorized Official - Middle Name:CURTIS
Authorized Official - Last Name:GALLAGHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-267-5030
Mailing Address - Street 1:4603 N HIGH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-2001
Mailing Address - Country:US
Mailing Address - Phone:614-267-5030
Mailing Address - Fax:514-267-5044
Practice Address - Street 1:4603 N HIGH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-2001
Practice Address - Country:US
Practice Address - Phone:614-267-5030
Practice Address - Fax:514-267-5044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-02
Last Update Date:2010-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.036132261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1376643114OtherNPI
OHGA0549371OtherMEDICARE
OHGA0549371OtherMEDICARE