Provider Demographics
NPI:1790027340
Name:OHIO AGING SERVICES NETWORK
Entity Type:Organization
Organization Name:OHIO AGING SERVICES NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CHAIRMAN
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:FORMAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-228-9131
Mailing Address - Street 1:17 S. HIGH ST.
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-3481
Mailing Address - Country:US
Mailing Address - Phone:614-228-9131
Mailing Address - Fax:614-228-7702
Practice Address - Street 1:17 S. HIGH ST.
Practice Address - Street 2:SUITE 1000
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-3481
Practice Address - Country:US
Practice Address - Phone:614-228-9131
Practice Address - Fax:614-228-7702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-21
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility