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Organization

NON-AGENCY RN

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ABU B. KALOKOH (RN)
(614) 209-6947
Entity
Organization

Contact information

Practice address
4665 E MAIN ST APT 17, COLUMBUS, OH 43213-3134
(614) 209-6947
Mailing address
4665 E MAIN ST APT 17, COLUMBUS, OH 43213-3134
(614) 209-6947

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
RN282042
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2606817
OH
Enumeration date
07/17/2006
Last updated
08/22/2020
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