Organization
OHIOHEALTH CORPORATION
Active
Parent organization
GRANT/RIVERSIDE MEDICAL CARE FOUNDATION, INC
Other names
MidOhio Cardiology and Vascular Consultants
Organization subpart
Yes
Provider details
NPI number
Legal business name
GRANT/RIVERSIDE MEDICAL CARE FOUNDATION, INC
Authorized official
TRACY A HEDGES CPCS (CREDENTIALING COORDINATOR)
(614) 544-6356
Entity
Organization
Contact information
Practice address
3705 OLENTANGY RIVER RD, SUITE 100, COLUMBUS, OH 43214-3467
(614) 262-6772
(614) 262-7074
Mailing address
5350 FRANTZ RD, DUBLIN, OH 43016-4259
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
—
207RI0011X
Interventional Cardiology Physician
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2885258
—
OH
Enumeration date
11/12/2008
Last updated
07/08/2011
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