Provider Demographics
NPI:1710996780
Name:ZANDEX INC
Entity Type:Organization
Organization Name:ZANDEX INC
Other - Org Name:50 PLUS THERAPY SPECIALIST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-588-2182
Mailing Address - Street 1:1122 TAYLOR ST
Mailing Address - Street 2:PO BOX 730
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-2658
Mailing Address - Country:US
Mailing Address - Phone:740-588-2182
Mailing Address - Fax:740-588-2185
Practice Address - Street 1:1122 TAYLOR ST
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-2658
Practice Address - Country:US
Practice Address - Phone:740-588-2182
Practice Address - Fax:740-588-2185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2323131Medicaid
OHDA1942OtherRAIL ROAD MEDICARE
OH000 000 224935OtherANTHEM
OH=========OtherTRI CARE
OHDA1942OtherRAIL ROAD MEDICARE
OH=========OtherTRI CARE