Provider Demographics
NPI:1952661373
Name:AIDS RESOURCE CENTER OHIO MEDICAL
Entity Type:Organization
Organization Name:AIDS RESOURCE CENTER OHIO MEDICAL
Other - Org Name:AIDS RESOURCE CENTER OHIO MEDICAL CENTER, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR - HEALTHCARE REVENUE CYCLE
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:S
Authorized Official - Last Name:BICKHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-340-6717
Mailing Address - Street 1:4400 N HIGH ST STE 300
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:614-340-6717
Mailing Address - Fax:614-340-6787
Practice Address - Street 1:1033 N HIGH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43201-2409
Practice Address - Country:US
Practice Address - Phone:614-340-6717
Practice Address - Fax:614-340-6787
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AIDS RESOURCE CENTER OHIO, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-05-18
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care