Provider Demographics
NPI:1326477829
Name:DUBLIN SPRINGS, LLC
Entity Type:Organization
Organization Name:DUBLIN SPRINGS, LLC
Other - Org Name:DUBLIN SPRINGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF LICENSE AND REGULATION
Authorized Official - Prefix:MS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:SALEE
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:812-598-8989
Mailing Address - Street 1:7625 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-9649
Mailing Address - Country:US
Mailing Address - Phone:614-717-1800
Mailing Address - Fax:614-717-1801
Practice Address - Street 1:7625 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-9649
Practice Address - Country:US
Practice Address - Phone:614-717-1800
Practice Address - Fax:614-717-1801
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DUBLIN SPRINGS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-11-05
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA03861NP363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCOA03861NPOtherLICENSE NUMBER