Provider Demographics
NPI:1801308887
Name:COLUMBUS MEDICAL SERVICES, LLC
Entity type:Organization
Organization Name:COLUMBUS MEDICAL SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CONTRACTS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:NOLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-229-5116
Mailing Address - Street 1:500 E SWEDESFORD RD STE 100
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-1614
Mailing Address - Country:US
Mailing Address - Phone:610-592-0292
Mailing Address - Fax:
Practice Address - Street 1:2333 ALEXANDRIA DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3215
Practice Address - Country:US
Practice Address - Phone:800-229-5116
Practice Address - Fax:888-379-2524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-30
Last Update Date:2017-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1376788505Medicaid
GA1477798601Medicaid
GA1750526984Medicaid
NJ1710406244Medicaid
GA1992950455Medicaid
GA1073768537Medicaid
IN1104020452Medicaid
FL1750820908Medicaid
GA1720233281Medicaid
MD1225561178Medicaid
DE1659805141Medicaid
SC1780911644Medicaid
TN1104020452Medicaid
KY1851811046Medicaid
GA1942455175Medicaid
GA1366687592Medicaid