Provider Demographics
NPI:1427025022
Name:THE CADUCEUS CORPORATION
Entity type:Organization
Organization Name:THE CADUCEUS CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:C
Authorized Official - Last Name:RYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-527-4581
Mailing Address - Street 1:5333 TRIPLE CROWN CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-5619
Mailing Address - Country:US
Mailing Address - Phone:614-527-4581
Mailing Address - Fax:614-573-6676
Practice Address - Street 1:5333 TRIPLE CROWN CT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-5619
Practice Address - Country:US
Practice Address - Phone:614-527-4581
Practice Address - Fax:614-573-6676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2400066332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2528830OtherMRDD WAIVER PROVIDER
OH2400066OtherBUREAU OF CHILDREN W/HAND
OH0002357Medicaid
OH2400066Medicaid