Basic Information
| Provider Information | |||||||||
| NPI: | 1780997213 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | THE OHIO STATE UNIVERSITY HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 410 W 10TH AVE | ||||||||
| Address2: | N-308 DOAN HALL | ||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432101240 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6142932458 | ||||||||
| FaxNumber: | 6142937273 | ||||||||
| Practice Location | |||||||||
| Address1: | 410 W 10TH AVE | ||||||||
| Address2: | N-308 DOAN HALL | ||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432101240 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6142932458 | ||||||||
| FaxNumber: | 6142937273 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2010 | ||||||||
| LastUpdateDate: | 07/26/2010 | ||||||||
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| AuthorizedOfficialLastName: | STASCHIAK | ||||||||
| AuthorizedOfficialFirstName: | GRETCHEN | ||||||||
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| AuthorizedOfficialTitleorPosition: | PATHOLOGY EDUCATION MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 6142932458 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 291U00000X | Y | Laboratories | Clinical Medical Laboratory |
No ID Information.