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General NPI Number Information
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NPI Number | 1417955170
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Entity Type | Organization
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Legal Business Name | NATIONWIDE CHILDREN'S HOSPITAL HOMECARE
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 05/02/2008
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Provider Practice Location Address
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Address Line | 255 E MAIN ST
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City | COLUMBUS
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State | OH
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Zip | 43215-5222
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Country | US
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Telephone | 614-355-1100
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Fax | 614-355-1182
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Provider Business Mailing Address
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Address Line | 255 E MAIN ST
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City | COLUMBUS
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State | OH
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Zip | 43215-5222
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Country | US
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Telephone | 614-355-1100
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Fax | 614-355-1182
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Authorized Official
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Title or Position | VP HOMECARE
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Name | WANDA STACKPOLE
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Credential | RN
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Telephone | 614-355-1100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number | BC3288455
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 0097-HSP
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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