| Homeland Clinic | |
|
3505 E Livingston Ave Ste G Columbus OH 43227-2252 | |
| (614) 632-1018 | |
| Not Available |
| Full Name | Homeland Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 3505 E Livingston Ave Ste G, Columbus, Ohio |
| Authorized Official Name and Position | Kingsley Eyong Enow (SUPERVISOR) |
| Authorized Official Contact | 6147158316 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Homeland Clinic 3505 E Livingston Ave Ste G Columbus OH 43227-2252 Ph: (614) 715-8216 | Homeland Clinic 3505 E Livingston Ave Ste G Columbus OH 43227-2252 Ph: (614) 632-1018 |
| NPI Number | 1356020515 |
|---|---|
| Provider Enumeration Date | 07/14/2023 |
| Last Update Date | 04/19/2024 |
| Certification Date | 04/19/2024 |
| Medicare PECOS PAC ID | 8426402736 |
|---|---|
| Medicare Enrollment ID | O20240404002235 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356020515 | NPI | - | NPPES |
| Provider Name | Kingsley Eyong Enow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477815892 PECOS PAC ID: 9335593649 Enrollment ID: I20240503003589 |
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