Provider Demographics
NPI:1508897687
Name:AMERICAN HEALTH NETWORK OF OHIO, LLC
Entity Type:Organization
Organization Name:AMERICAN HEALTH NETWORK OF OHIO, LLC
Other - Org Name:AMERICAN HEALTH NETWORK OF OHIO PROFESSIONAL CORPORATION
Other - Org Type:Other Name
Authorized Official - Title/Position:VP OPERATIONS OHIO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:A
Authorized Official - Last Name:COURTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-794-5053
Mailing Address - Street 1:4278 INDIANOLA AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-2806
Mailing Address - Country:US
Mailing Address - Phone:614-262-0477
Mailing Address - Fax:614-268-1677
Practice Address - Street 1:4278 INDIANOLA AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-2806
Practice Address - Country:US
Practice Address - Phone:614-262-0477
Practice Address - Fax:614-268-1677
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMERICAN HEALTH NETWORK OF OHIO, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-06
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredGroup - Multi-Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2731780Medicaid
OHCA9318OtherRAIL ROAD MEDICARE
OHCA9318OtherRAIL ROAD MEDICARE
OH1062950010Medicare NSC