Organization
EQUITAS HEALTH, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN C WILLIS (PAYER CREDENTIALING MANAGER)
(833) 378-4827
Entity
Organization
Contact information
Practice address
750 E LONG ST, COLUMBUS, OH 43203-1846
(833) 378-4827
(833) 222-8164
Mailing address
1105 SCHROCK RD STE 400, COLUMBUS, OH 43229-1174
(833) 378-4827
(833) 222-8164
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0318260
—
OH
Enumeration date
06/15/2018
Last updated
04/03/2026
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