# OHIOHEALTH CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** GRANT/RIVERSIDE MEDICAL CARE FOUNDATION, INC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619276656
- **Authorized official:** MARK WUESTEWALD (DIRECTOR OF REVENUE CYCLE)
- **Authorized official phone:** (614) 544-6351

## Contact information

- **Practice address:** 3705 OLENTANGY RIVER RD STE 260, COLUMBUS, OH 43214-3467
- **Practice address phone:** (614) 586-1220
- **Practice address fax:** (614) 586-1237
- **Mailing address:** 5350 FRANTZ RD, DUBLIN, OH 43016-4259
- **Mailing address phone:** (614) 544-6356
- **Mailing address fax:** (614) 544-6370

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207RS0010X | Sports Medicine (Internal Medicine) Physician | — | — | — |

## Other

- **Enumeration date:** 03/16/2011
- **Last updated:** 03/16/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2083347 | — | OH |