Provider Demographics
NPI:1811324296
Name:COLUMBUS STATE UNIVERSITY
Entity type:Organization
Organization Name:COLUMBUS STATE UNIVERSITY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP BUSINESS & FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:J
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:HELTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-507-8900
Mailing Address - Street 1:4225 UNIVERSITY AVE
Mailing Address - Street 2:ATHLETICS LUMPKIN CENTER RM 124
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31907-5679
Mailing Address - Country:US
Mailing Address - Phone:706-565-4332
Mailing Address - Fax:706-569-3435
Practice Address - Street 1:4225 UNIVERSITY AVE
Practice Address - Street 2:ATHLETICS LUMPKIN CENTER RM 124
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31907-5679
Practice Address - Country:US
Practice Address - Phone:706-565-4332
Practice Address - Fax:706-569-3435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-01
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health