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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