Organization
COLUMBUS NEIGHBORHOOD HEALTH CENTER, INC.
Active
Other names
PrimaryOne Health
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLETA B TAVARES (CEO)
(614) 859-1946
Entity
Organization
Contact information
Practice address
600 N PICKAWAY ST, SUITE 300 MO BUILDING, CIRCLEVILLE, OH 43113-1447
(740) 207-4202
(740) 207-4221
Mailing address
2780 AIRPORT DR STE 100, COLUMBUS, OH 43219-2289
(614) 859-1906
(614) 645-5517
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0104410
—
OH
01
—
361044
MEDICARE PART A
OH
01
—
36D2070605
CLIA
OH
Enumeration date
01/13/2014
Last updated
01/26/2024
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