| Columbus Vascular Medicine Inc | |
|
285 E State St Ste 460a Columbus OH 43215-4354 | |
| (614) 228-8272 | |
| (614) 228-8271 |
| Full Name | Columbus Vascular Medicine Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 285 E State St, Columbus, Ohio |
| Authorized Official Name and Position | Randall Slaybaugh (PRESIDENT) |
| Authorized Official Contact | 6142288272 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Columbus Vascular Medicine Inc 285 E State St Ste 460a Columbus OH 43215-4354 Ph: (614) 228-8272 | Columbus Vascular Medicine Inc 285 E State St Ste 460a Columbus OH 43215-4354 Ph: (614) 228-8272 |
| NPI Number | 1679511182 |
|---|---|
| Provider Enumeration Date | 06/04/2006 |
| Last Update Date | 11/26/2014 |
| Medicare PECOS PAC ID | 5799797593 |
|---|---|
| Medicare Enrollment ID | O20060618000001 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679511182 | NPI | - | NPPES |
| 2824555 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 35071159S (Ohio) | Primary |
| Provider Name | Randall Scott Slaybaugh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609837335 PECOS PAC ID: 5698787349 Enrollment ID: I20060620000070 |
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