| Columbus Chronic Care Medical Center Llc | |
|
506 Mccutcheon Rd Gahanna OH 43230-5001 | |
| (614) 496-8420 | |
| Not Available |
| Full Name | Columbus Chronic Care Medical Center Llc |
|---|---|
| Speciality | Nurse Practitioner - Family |
| Location | 506 Mccutcheon Rd, Gahanna, Ohio |
| Authorized Official Name and Position | Mulllissa Childress (CEO) |
| Authorized Official Contact | 6144968420 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Columbus Chronic Care Medical Center Llc 5300 Bright Sun Ct Las Vegas NV 89130-3728 Ph: (614) 496-8420 | Columbus Chronic Care Medical Center Llc 506 Mccutcheon Rd Gahanna OH 43230-5001 Ph: (614) 496-8420 |
| NPI Number | 1295122521 |
|---|---|
| Provider Enumeration Date | 04/24/2015 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295122521 | NPI | - | NPPES |
| 0129662 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 16446-NP (Ohio) | Primary |
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