| Careconnectmd Ohio, LLC | |
|
20 S 3rd St Ste 210 Columbus OH 43215-4206 | |
| (888) 789-9585 | |
| Not Available |
| Full Name | Careconnectmd Ohio, LLC |
|---|---|
| Speciality | General Practice |
| Location | 20 S 3rd St Ste 210, Columbus, Ohio |
| Authorized Official Name and Position | Kim Phan (CEO) |
| Authorized Official Contact | 8887899585 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Careconnectmd Ohio, LLC 3090 Bristol St Ste 200 Costa Mesa CA 92626-3061 Ph: (888) 789-9585 | Careconnectmd Ohio, LLC 20 S 3rd St Ste 210 Columbus OH 43215-4206 Ph: (888) 789-9585 |
| NPI Number | 1255971537 |
|---|---|
| Provider Enumeration Date | 01/14/2020 |
| Last Update Date | 02/09/2024 |
| Certification Date | 02/09/2024 |
| Medicare PECOS PAC ID | 2567885577 |
|---|---|
| Medicare Enrollment ID | O20200709002068 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255971537 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | () | Primary |
| Provider Name | Jacinta K Ford |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1669776753 PECOS PAC ID: 1052591435 Enrollment ID: I20110203000015 |
| Provider Name | Orlando Collado |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205964947 PECOS PAC ID: 8820143134 Enrollment ID: I20260219000208 |
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