Basic Information
| Provider Information | |||||||||
| NPI: | 1568617405 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JOHNSON HEALTH LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 99 N BRICE RD | ||||||||
| Address2: | SUITE 360 | ||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432136510 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6143677700 | ||||||||
| FaxNumber: | 8009487705 | ||||||||
| Practice Location | |||||||||
| Address1: | 99 N BRICE RD | ||||||||
| Address2: | SUITE 360 | ||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432136510 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6143677700 | ||||||||
| FaxNumber: | 8009487705 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/19/2008 | ||||||||
| LastUpdateDate: | 11/19/2008 | ||||||||
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| AuthorizedOfficialLastName: | JOHNSON | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 6143677700 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 253Z00000X | 2523326 | OH | Y | Agencies | In Home Supportive Care |
No ID Information.