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General NPI Number Information
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NPI Number | 1033554910
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Entity Type | Organization
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Legal Business Name | NATIONWIDE CHILDREN'S HIOSPITAL
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Dates
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Enumeration Date | 05/06/2013
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Last Update Date | 05/06/2013
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Provider Practice Location Address
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Address Line | 5680 VENTURE DR
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City | DUBLIN
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State | OH
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Zip | 43017-2190
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Country | US
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Telephone | 614-355-8737
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Fax | 614-355-8710
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Provider Business Mailing Address
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Address Line | 5680 VENTURE DR
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City | DUBLIN
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State | OH
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Zip | 43017-2190
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Country | US
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Telephone | 614-355-8737
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Fax | 614-355-8710
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Authorized Official
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Title or Position | PROGRAM MANAGER
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Name | MISS LISA KLUCHUROSKY
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Credential | ATC
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Telephone | 614-355-6020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | AT-001784
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License Number State | OH
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