Provider Demographics
NPI:1578999553
Name:CENTRAL OHIO SPECIALTY CARE, LLC
Entity Type:Organization
Organization Name:CENTRAL OHIO SPECIALTY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NICK
Authorized Official - Middle Name:
Authorized Official - Last Name:KALOGERAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-790-0200
Mailing Address - Street 1:2349 WESTBROOKE DR
Mailing Address - Street 2:BLDG A
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43228-9557
Mailing Address - Country:US
Mailing Address - Phone:614-790-0200
Mailing Address - Fax:614-754-5084
Practice Address - Street 1:2349 WESTBROOKE DR
Practice Address - Street 2:BLDG A
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-9557
Practice Address - Country:US
Practice Address - Phone:614-790-0200
Practice Address - Fax:614-754-5084
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVANCED MEDICAL EQUIPMENT, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-09-23
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHHMER.22969-JCHO332B00000X
332BP3500X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0118529Medicaid