Basic Information
| Provider Information | |||||||||
| NPI: | 1316283690 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | THE OHIO STATE UNIVERSITY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 915 OLENTANGY RIVER ROAD | ||||||||
| Address2: | SUITE 2140 | ||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 43212 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 915 OLENTANGY RIVER ROAD | ||||||||
| Address2: | SUITE 2140 | ||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 43212 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6142938566 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/14/2012 | ||||||||
| LastUpdateDate: | 12/14/2012 | ||||||||
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| AuthorizedOfficialLastName: | BROM | ||||||||
| AuthorizedOfficialFirstName: | HEATHER | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR OF MIDLEVEL PROVIDERS | ||||||||
| AuthorizedOfficialTelephone: | 6143663776 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | NP | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | Y | Hospitals | General Acute Care Hospital |
No ID Information.