Healthcare Provider Details

I. General information

NPI: 1861506560
Provider Name (Legal Business Name): CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 11/18/2021
Certification Date: 10/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PERKINS SQ
AKRON OH
44308-1062
US

IV. Provider business mailing address

1 PERKINS SQ
AKRON OH
44308-1062
US

V. Phone/Fax

Practice location:
  • Phone: 330-543-8171
  • Fax: 330-543-3616
Mailing address:
  • Phone: 330-543-8171
  • Fax: 330-543-3616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License NumberNA
License Number StateOH

VIII. Authorized Official

Name: MRS. ALICIA E LAMANCUSA
Title or Position: DIRECTOR FINANCE
Credential: CPA
Phone: 330-543-8171