Provider Demographics
NPI:1447723747
Name:COLUMBUS MEDICAL SERVICES, LLC
Entity type:Organization
Organization Name:COLUMBUS MEDICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BIDS & CONTRACTS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:NOLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-229-5116
Mailing Address - Street 1:500 E SWEDESFORD RD STE 100
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-1614
Mailing Address - Country:US
Mailing Address - Phone:800-229-5116
Mailing Address - Fax:888-379-2524
Practice Address - Street 1:235 W ROOSEVELT AVE STE 455
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701-2657
Practice Address - Country:US
Practice Address - Phone:229-435-3212
Practice Address - Fax:229-317-7209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-09
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000979052GMedicaid
GA000979052KMedicaid
GA000979052DMedicaid
GA000979052EMedicaid
GA000979052FMedicaid
GA000979052HMedicaid
GA000979052IMedicaid
GA000979052JMedicaid