Provider Demographics
NPI:1437299617
Name:COLUMBUS PULMONARY ASSOCIATES, INC.
Entity Type:Organization
Organization Name:COLUMBUS PULMONARY ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:JO
Authorized Official - Last Name:LEATHERWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-577-8302
Mailing Address - Street 1:85 MCNAUGHTEN RD STE 130
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-5111
Mailing Address - Country:US
Mailing Address - Phone:614-577-8322
Mailing Address - Fax:614-577-8302
Practice Address - Street 1:85 MCNAUGHTEN RD STE 130
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-5111
Practice Address - Country:US
Practice Address - Phone:614-577-8322
Practice Address - Fax:614-577-8302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0598090Medicaid
OHA17385Medicare UPIN
OHE67578Medicare UPIN
OH9919954Medicare PIN
OH0598090Medicaid
OH9919952Medicare PIN
OH9919953Medicare PIN