| Primaryone Health | |
|
2300 W Broad St Columbus OH 43204-3783 | |
| (614) 645-2300 | |
| (614) 645-2333 |
| Full Name | Primaryone Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 2300 W Broad St, Columbus, Ohio |
| Authorized Official Name and Position | Charleta B Tavares (CEO) |
| Authorized Official Contact | 6148591946 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primaryone Health 2780 Airport Dr Ste 100 Columbus OH 43219-2289 Ph: (614) 859-1906 | Primaryone Health 2300 W Broad St Columbus OH 43204-3783 Ph: (614) 645-2300 |
| NPI Number | 1497817142 |
|---|---|
| Provider Enumeration Date | 12/15/2006 |
| Last Update Date | 01/26/2024 |
| Medicare PECOS PAC ID | 3678469129 |
|---|---|
| Medicare Enrollment ID | O20110713000867 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497817142 | NPI | - | NPPES |
| 2051176 | Medicaid | OH | |
| 36D0328844 | Other | OH | CLIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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