| Central Ohio Medical Management Llc | |
|
1755 Lancaster Ave Reynoldsburg OH 43068-3108 | |
| (614) 577-1948 | |
| (614) 577-1948 |
| Full Name | Central Ohio Medical Management Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1755 Lancaster Ave, Reynoldsburg, Ohio |
| Authorized Official Name and Position | Gina Marie Nichols (CEO) |
| Authorized Official Contact | 6145771948 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Central Ohio Medical Management Llc Po Box 513 Pickerington OH 43147-0513 Ph: (614) 577-1948 | Central Ohio Medical Management Llc 1755 Lancaster Ave Reynoldsburg OH 43068-3108 Ph: (614) 577-1948 |
| NPI Number | 1962901678 |
|---|---|
| Provider Enumeration Date | 02/08/2018 |
| Last Update Date | 04/20/2018 |
| Medicare PECOS PAC ID | 7315292638 |
|---|---|
| Medicare Enrollment ID | O20180608001961 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962901678 | NPI | - | NPPES |
| 2611267 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 35.086704 (Ohio) | Primary |
| Provider Name | Gina M Nichols |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821026451 PECOS PAC ID: 6709810740 Enrollment ID: I20050920000740 |
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