Provider Demographics
NPI:1952578338
Name:CENTRAL OHIO UROLOGY GROUP LLC
Entity Type:Organization
Organization Name:CENTRAL OHIO UROLOGY GROUP LLC
Other - Org Name:OLENTANGY DUBLIN
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:GIACOMELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-396-2635
Mailing Address - Street 1:7450 HOSPITAL DRIVE
Mailing Address - Street 2:SUITE 350
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016
Mailing Address - Country:US
Mailing Address - Phone:614-268-2323
Mailing Address - Fax:614-268-8103
Practice Address - Street 1:7405 HOSPITAL DRIVE
Practice Address - Street 2:SUITE 350
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016
Practice Address - Country:US
Practice Address - Phone:614-268-2323
Practice Address - Fax:614-268-8103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-14
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty