Provider Demographics
NPI:1023078516
Name:HEART SPECIALISTS OF OHIO, INC.
Entity type:Organization
Organization Name:HEART SPECIALISTS OF OHIO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/TREASURER, MANAGING PARTN
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:MURCKO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-538-0527
Mailing Address - Street 1:3650 OLENTANGY RIVER RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3464
Mailing Address - Country:US
Mailing Address - Phone:614-538-0530
Mailing Address - Fax:
Practice Address - Street 1:3650 OLENTANGY RIVER RD
Practice Address - Street 2:SUITE 300
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3464
Practice Address - Country:US
Practice Address - Phone:614-538-0530
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-27
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0214637Medicaid
OH0214637Medicaid