HIS GRACE MEDICAL LLC NPI 1346420668

NPI Information

NPI: 1346420668
Provider Name: HIS GRACE MEDICAL LLC

Former Legal Business Name: 6055 CLEVELAND AVENUE

Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
6055 CLEVELAND AVE
COLUMBUS, OH
ZIP 43231
Phone: (614) 315-1836
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HIS GRACE MEDICAL LLC is a primary care clinic center in Columbus, OH. HIS GRACE MEDICAL LLC NPI is 1346420668. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is 6055 Cleveland Avenue.

The provider's business location address is:

6055 CLEVELAND AVE
COLUMBUS, OH
ZIP 43231-256
Phone: (614) 315-1836
Fax: (888) 491-4030

The provider's authorized official is Feyisayo Oluwatosin Tolani .
The authorized official title is Rn/office Manager and has the following contact phone number (614) 315-1836.

The enumeration date for this NPI number is 11/5/2007 and was last updated on 1/22/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	35084618	OHIO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	2509020	MEDICAID	OHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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