=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437606324
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AKRON CHILDREN'S HOSPITAL HEMOPHILIA TREATMENT CENTER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/08/2016
-----------------------------------------------------
Last Update Date | 09/08/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1 PERKINS SQUARE
-----------------------------------------------------
City | AKRON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44308-1062
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-543-1000
-----------------------------------------------------
Fax | 330-543-3616
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1 PERKINS SQUARE
-----------------------------------------------------
City | AKRON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44308-1062
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-543-1000
-----------------------------------------------------
Fax | 330-543-3616
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIEF FINANCIAL OFFICER & TREASURER
-----------------------------------------------------
Name | MR. MICHAEL TRAINER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 330-543-4251
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336H0001X
-----------------------------------------------------
Taxonomy Name | Home Infusion Therapy Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------