Provider Demographics
NPI:1285639062
Name:OHIO ORTHOPEDIC SURGERY INSTITUTE LLC
Entity Type:Organization
Organization Name:OHIO ORTHOPEDIC SURGERY INSTITUTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:B
Authorized Official - Last Name:SAUL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:614-827-8777
Mailing Address - Street 1:PO BOX 633607
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-3607
Mailing Address - Country:US
Mailing Address - Phone:614-827-8777
Mailing Address - Fax:614-488-7864
Practice Address - Street 1:4605 SAWMILL RD
Practice Address - Street 2:STE 101
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-2246
Practice Address - Country:US
Practice Address - Phone:614-827-8777
Practice Address - Fax:614-488-7864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-17
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0712AS261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000282681OtherANTHEM ASC PROVIDER NUMBE
OH200894000OtherDEPT OF LABOR ASC
OHP00085241OtherMEDICARE RAILROAD ASC
OH2445081Medicaid
OH200894000OtherDEPT OF LABOR ASC
OH000000282681OtherANTHEM ASC PROVIDER NUMBE
OH=========003OtherMEDICAL MUTUAL ASC
OH=========003OtherMEDICAL MUTUAL ASC