EASTGLEN PEDIATRICS INC. NPI 1659413839

NPI Information

NPI: 1659413839
Provider Name: EASTGLEN PEDIATRICS, INC.
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
6495 E BROAD ST
SUITE A
COLUMBUS, OH
ZIP 43213
Phone: (614) 866-8077
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EASTGLEN PEDIATRICS, INC. is a primary care clinic center in Columbus, OH. EASTGLEN PEDIATRICS, INC. NPI is 1659413839. The provider is registered as an organization entity type.

The provider's business location address is:

6495 E BROAD ST
SUITE A
COLUMBUS, OH
ZIP 43213-541
Phone: (614) 866-8077
Fax: (614) 866-9752

The provider's authorized official is L. Robert Polster .
The authorized official title is President and has the following contact phone number (614) 866-8077.

The enumeration date for this NPI number is 2/13/2007 and was last updated on 8/22/2020.

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	35031032	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	0222244	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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