Healthcare Provider Details

I. General information

NPI: 1699985481
Provider Name (Legal Business Name): COLUMBUS CHILDREN'S HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 09/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 CHILDRENS DR
COLUMBUS OH
43205-2664
US

IV. Provider business mailing address

700 CHILDRENS DR
COLUMBUS OH
43205-2664
US

V. Phone/Fax

Practice location:
  • Phone: 614-722-3553
  • Fax: 614-722-3699
Mailing address:
  • Phone: 614-722-3553
  • Fax: 614-722-3699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number34008593
License Number StateOH

VIII. Authorized Official

Name: STEVEN ALLEN
Title or Position: CEO
Credential: MD
Phone: 614-722-4561