Provider Demographics
NPI:1639519838
Name:WEXNER MEDICAL CENTER AT OHIO STATE UNIVERSITY
Entity Type:Organization
Organization Name:WEXNER MEDICAL CENTER AT OHIO STATE UNIVERSITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENCY PROGRAM COORDINATO
Authorized Official - Prefix:MS
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HARR-WEATHERBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-293-3551
Mailing Address - Street 1:376 WEST 10TH AVENUE
Mailing Address - Street 2:776 PRIOR HALL
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43210
Mailing Address - Country:US
Mailing Address - Phone:614-293-3551
Mailing Address - Fax:
Practice Address - Street 1:376 WEST 10TH AVENUE
Practice Address - Street 2:776 PRIOR HALL
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210
Practice Address - Country:US
Practice Address - Phone:614-293-3551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-02
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital