Provider Demographics
NPI:1588285712
Name:SPRINGWAY MEDICAL AND ADDICTION TREATMENT CENTER
Entity type:Organization
Organization Name:SPRINGWAY MEDICAL AND ADDICTION TREATMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AKWASI
Authorized Official - Middle Name:
Authorized Official - Last Name:AGYEMANG
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:614-725-6035
Mailing Address - Street 1:4770 INDIANOLA AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-1876
Mailing Address - Country:US
Mailing Address - Phone:614-725-6035
Mailing Address - Fax:614-987-6108
Practice Address - Street 1:4770 INDIANOLA AVE STE 201
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-1876
Practice Address - Country:US
Practice Address - Phone:614-725-6035
Practice Address - Fax:614-987-6108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-28
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0312220Medicaid