Healthcare Provider Details

I. General information

NPI: 1235303926
Provider Name (Legal Business Name): NATIONWIDE CHILDRENS HOSPITAL HOMECARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2008
Last Update Date: 04/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 E MAIN ST
COLUMBUS OH
43215-5222
US

IV. Provider business mailing address

255 E MAIN ST
COLUMBUS OH
43215-5222
US

V. Phone/Fax

Practice location:
  • Phone: 614-355-1100
  • Fax: 614-355-1182
Mailing address:
  • Phone: 614-355-1100
  • Fax: 614-355-1182

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: WANDA STACKPOLE
Title or Position: VICE PRESIDENT
Credential: RN
Phone: 614-355-1100