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Organization
PENNINGTON GAP
Active
Organization
PENNINGTON GAP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY BROADNAX (CEO)
(614) 401-7700
Entity
Organization
Contact information
Practice address
20 S 3RD ST STE 210, COLUMBUS, OH 43215-4206
(614) 401-7700
Mailing address
20 S 3RD ST STE 210, COLUMBUS, OH 43215-4206
(614) 401-7700
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
10/30/2023
Last updated
09/11/2025
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