Provider Demographics
NPI:1649223553
Name:INFINITY NP OF COLUMBUS, LLC
Entity Type:Organization
Organization Name:INFINITY NP OF COLUMBUS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:COURY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-250-3560
Mailing Address - Street 1:24165 DETROIT RD
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-1516
Mailing Address - Country:US
Mailing Address - Phone:440-250-3560
Mailing Address - Fax:440-617-1815
Practice Address - Street 1:757 BROOKSEDGE PLAZA DR
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-4913
Practice Address - Country:US
Practice Address - Phone:614-818-6156
Practice Address - Fax:614-818-3906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty