Basic Information
| Provider Information | |||||||||
| NPI: | 1073893756 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | OSU MEDICAL CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 320 W 10TH AVE | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432101280 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6143663733 | ||||||||
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| Practice Location | |||||||||
| Address1: | 320 W 10TH AVE | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432101280 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6143663733 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/25/2011 | ||||||||
| LastUpdateDate: | 08/25/2011 | ||||||||
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| AuthorizedOfficialLastName: | HOFFMAN | ||||||||
| AuthorizedOfficialFirstName: | LISA | ||||||||
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| AuthorizedOfficialTitleorPosition: | ADVANCED PRACTICE EDUCATOR | ||||||||
| AuthorizedOfficialTelephone: | 6142938735 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 284300000X | Y | Hospitals | Special Hospital |
No ID Information.