Healthcare Provider Details

I. General information

NPI: 1275666471
Provider Name (Legal Business Name): CHILD HEALTH SYSTEMS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8509 BENJAMIN ROAD SUITE A D
TAMPA FL
33634-1224
US

IV. Provider business mailing address

8509 BENJAMIN ROAD SUITE A D
TAMPA FL
33634-1224
US

V. Phone/Fax

Practice location:
  • Phone: 813-880-0220
  • Fax: 813-880-0221
Mailing address:
  • Phone: 813-880-0220
  • Fax: 813-880-0221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPH12832
License Number StateFL

VIII. Authorized Official

Name: MRS. HUONG L TRAN
Title or Position: VICE PRESIDENT
Credential:
Phone: 813-880-0220