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General NPI Number Information
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NPI Number | 1366580391
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Entity Type | Organization
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Legal Business Name | CHILDREN'S HOSPITAL MEDICAL CENTER
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 08/05/2020
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Provider Practice Location Address
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Address Line | 660 LINCOLN AVE
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City | CINCINNATI
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State | OH
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Zip | 45206-1100
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Country | US
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Telephone | 513-636-4225
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Fax | 513-636-2511
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Provider Business Mailing Address
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Address Line | 3337 SOLUTIONS CENTER BOX 773337
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City | CHICAGO
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State | IL
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Zip | 60677-3003
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Country | US
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Telephone | 513-636-4225
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Fax | 513-636-2511
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Authorized Official
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Title or Position | SR DIRECTOR BILLING & CODING SERV
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Name | MRS. JODIANNE BROOMALL
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Credential |
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Telephone | 513-636-5047
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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