Provider Demographics
NPI:1346207503
Name:NETCARE CORPORATION
Entity Type:Organization
Organization Name:NETCARE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:A
Authorized Official - Middle Name:KING
Authorized Official - Last Name:STUMPP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-274-9500
Mailing Address - Street 1:199 S CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43223-5300
Mailing Address - Country:US
Mailing Address - Phone:614-274-9500
Mailing Address - Fax:614-279-0925
Practice Address - Street 1:199 S CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUJS
Practice Address - State:OH
Practice Address - Zip Code:43223-5300
Practice Address - Country:US
Practice Address - Phone:614-274-9500
Practice Address - Fax:614-279-0925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-28
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH02589OtherMACSIS UPI
OH0320727Medicaid
OH02589OtherMACSIS UPI