Provider Demographics
NPI:1922034578
Name:OSU JAMESCARE EAST HOSPSITAL
Entity Type:Organization
Organization Name:OSU JAMESCARE EAST HOSPSITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:M
Authorized Official - Last Name:GHANY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-257-2900
Mailing Address - Street 1:4199 HAYMAKER LN
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-1568
Mailing Address - Country:US
Mailing Address - Phone:614-766-2397
Mailing Address - Fax:
Practice Address - Street 1:1492 E BROAD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-1546
Practice Address - Country:US
Practice Address - Phone:614-257-2900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH058949174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0777637Medicaid
OHTAX ID NUMBEROtherTAX ID #
OH0777637Medicaid
OHGH0694291Medicare ID - Type UnspecifiedMEDICARE #