Provider Demographics
NPI:1336581834
Name:COLUMBUS OUTPATIENT CENTER
Entity Type:Organization
Organization Name:COLUMBUS OUTPATIENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BELINDA
Authorized Official - Middle Name:R
Authorized Official - Last Name:GOODWIN
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:614-537-2290
Mailing Address - Street 1:553 E TOWN ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-4927
Mailing Address - Country:US
Mailing Address - Phone:800-229-3514
Mailing Address - Fax:614-254-6625
Practice Address - Street 1:553 E TOWN ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-4927
Practice Address - Country:US
Practice Address - Phone:800-229-3514
Practice Address - Fax:614-254-6625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-24
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes305S00000XManaged Care OrganizationsPoint of Service
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty