Provider Demographics
NPI:1104138502
Name:MOLINA HEALTHCARE OF OHIO
Entity type:Organization
Organization Name:MOLINA HEALTHCARE OF OHIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MANCINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-562-5442
Mailing Address - Street 1:PO BOX 349020
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43234-9020
Mailing Address - Country:US
Mailing Address - Phone:800-642-4168
Mailing Address - Fax:614-781-1537
Practice Address - Street 1:8101 N HIGH ST
Practice Address - Street 2:STE 130
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-1406
Practice Address - Country:US
Practice Address - Phone:800-642-4168
Practice Address - Fax:614-781-1537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-14
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization