Provider Demographics
NPI:1528544467
Name:COLUMBUS MEDICAL SERVICES, LLC
Entity Type:Organization
Organization Name:COLUMBUS MEDICAL SERVICES, LLC
Other - Org Name:THE COLUMBUS ORGANIZATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTRACTS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:NOLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-229-5116
Mailing Address - Street 1:500 E SWEDESFORD RD STE 100
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-1614
Mailing Address - Country:US
Mailing Address - Phone:800-229-5116
Mailing Address - Fax:
Practice Address - Street 1:2150 S 1300 E STE 500
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84106
Practice Address - Country:US
Practice Address - Phone:800-229-5116
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-13
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201087800Medicaid
KY7100531280Medicaid
TN1512668Medicaid
NJ0622478Medicaid
KY7100472200Medicaid
IN201212480Medicaid
GA000979052Medicaid