Provider Demographics
NPI:1881093458
Name:METHODIST ELDERCARE PHYSICIAN SERVICES INC.
Entity type:Organization
Organization Name:METHODIST ELDERCARE PHYSICIAN SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:WEHNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-888-7492
Mailing Address - Street 1:155 FENWAY RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-1407
Mailing Address - Country:US
Mailing Address - Phone:614-888-7492
Mailing Address - Fax:
Practice Address - Street 1:155 FENWAY RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-1407
Practice Address - Country:US
Practice Address - Phone:614-888-7492
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:METHODIST ELDERCARE SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-08-19
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility