Provider Demographics
NPI:1831254762
Name:COLUMBUS NEIGHBORHOOD HEALTH CENTER, INC.
Entity type:Organization
Organization Name:COLUMBUS NEIGHBORHOOD HEALTH CENTER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRIGID
Authorized Official - Middle Name:L
Authorized Official - Last Name:EVERHART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-645-5500
Mailing Address - Street 1:2780 AIRPORT DR STE 100
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-2289
Mailing Address - Country:US
Mailing Address - Phone:614-859-1906
Mailing Address - Fax:614-645-5517
Practice Address - Street 1:2300 W BROAD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43204
Practice Address - Country:US
Practice Address - Phone:614-645-2300
Practice Address - Fax:614-645-2333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2051176Medicaid
36-1871Medicare ID - Type Unspecified