Provider Demographics
NPI:1659976173
Name:EQUITAS HEALTH, INC
Entity Type:Organization
Organization Name:EQUITAS HEALTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL BILLING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHERER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-340-6723
Mailing Address - Street 1:4400 N HIGH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-2635
Mailing Address - Country:US
Mailing Address - Phone:614-340-6777
Mailing Address - Fax:
Practice Address - Street 1:4400 N HIGH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-2635
Practice Address - Country:US
Practice Address - Phone:614-340-6777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EQUITAS HEALTH, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0068920Medicaid