Provider Demographics
NPI:1730126145
Name:OHIO HEART LLC
Entity type:Organization
Organization Name:OHIO HEART LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:RICHARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-378-5900
Mailing Address - Street 1:5128 WINTERBURG WAY
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-5235
Mailing Address - Country:US
Mailing Address - Phone:614-476-2222
Mailing Address - Fax:
Practice Address - Street 1:4625 MORSE RD
Practice Address - Street 2:SUITE #100
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-8355
Practice Address - Country:US
Practice Address - Phone:614-476-2222
Practice Address - Fax:614-476-5761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0668IC261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0668-ICOtherODH HEALTH CARE FACILITY
OH0668-ICOtherODH HEALTH CARE FACILITY