Provider Demographics
NPI:1679027973
Name:LOCAL PUBLIC HEALTH SERVICES COLLABORATIVE LLC
Entity Type:Organization
Organization Name:LOCAL PUBLIC HEALTH SERVICES COLLABORATIVE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MS
Authorized Official - First Name:BETH
Authorized Official - Middle Name:E
Authorized Official - Last Name:BICKFORD
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RN, CNS
Authorized Official - Phone:614-846-1911
Mailing Address - Street 1:110 NORTHWOODS BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-4723
Mailing Address - Country:US
Mailing Address - Phone:614-846-1911
Mailing Address - Fax:614-781-9558
Practice Address - Street 1:9880 MURRAY RIDGE RD
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-6957
Practice Address - Country:US
Practice Address - Phone:440-322-6367
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-04
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local