Provider Demographics
NPI:1447855671
Name:SMD MANAGEMENT LLC
Entity type:Organization
Organization Name:SMD MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SIDI
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAKITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-841-9774
Mailing Address - Street 1:2887 JOHNSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-1719
Mailing Address - Country:US
Mailing Address - Phone:614-841-9774
Mailing Address - Fax:614-841-9778
Practice Address - Street 1:2887 JOHNSTOWN RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-1719
Practice Address - Country:US
Practice Address - Phone:614-841-9774
Practice Address - Fax:614-841-9778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-04
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No253Z00000XAgenciesIn Home Supportive Care
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate VehicleGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2840297Medicaid