Organization
OHIO UNIVERSITY
Active
Organization
OHIO UNIVERSITY
Active
Parent organization
OHIO UNIVERSITY
Other names
Ohio University Therapy Associates
Organization subpart
Yes
Provider details
NPI number
Legal business name
OHIO UNIVERSITY
Authorized official
DR. MARIANNE S MALAWISTA PHD,MA-CCC,SLP (COORDINATOR OF CLINICAL SERVICES)
(740) 593-1418
Entity
Organization
Contact information
Practice address
W174 GROVER CENTER, ATHENS, OH 45701
(740) 593-1404
(740) 593-4433
Mailing address
W174 GROVER CENTER, ATHENS, OH 45701
(740) 593-1404
(740) 593-4433
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
A01437
OH
332S00000X
Hearing Aid Equipment
Primary
A01437
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000246469
BLUE CROSS/BLUE SHIELD
OH
05
—
0058187
—
OH
Enumeration date
11/30/2011
Last updated
10/12/2012
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