Provider Demographics
NPI:1023082716
Name:STATE OF OHIO OFFICE OF BUDGET AND MANAGEMENT STATE ACCOUNTING
Entity type:Organization
Organization Name:STATE OF OHIO OFFICE OF BUDGET AND MANAGEMENT STATE ACCOUNTING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:BANKS
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:513-948-3600
Mailing Address - Street 1:30 E BROAD ST
Mailing Address - Street 2:11TH FL, ATTN:TONYA FASONE
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-3414
Mailing Address - Country:US
Mailing Address - Phone:614-466-9930
Mailing Address - Fax:614-644-9116
Practice Address - Street 1:1101 SUMMIT RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45237-2621
Practice Address - Country:US
Practice Address - Phone:513-948-3600
Practice Address - Fax:513-948-3080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-17
Last Update Date:2010-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NA283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0150287Medicaid
OH9317556Medicare PIN
OH0150287Medicaid