=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932448248
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NATIONWIDE CHILDRENS HOSPITAL
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/06/2013
-----------------------------------------------------
Last Update Date | 02/06/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 700 CHILDREN'S DRIVE NATIONWIDE CHILDRENS HOSPITAL
-----------------------------------------------------
City | COLUMBUS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43205-2664
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-722-2000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 700 CHILDRENS DRIVE NATIONWIDE CHILDRENS HOSPITAL
-----------------------------------------------------
City | COLUMBUS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43205-0000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-722-2000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIVISION CHIEF
-----------------------------------------------------
Name | DR. OLIVIA THOMAS
-----------------------------------------------------
Credential | M.D
-----------------------------------------------------
Telephone | 614-722-4950
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QU0200X
-----------------------------------------------------
Taxonomy Name | Urgent Care Clinic/Center
-----------------------------------------------------
License Number | 096044
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 261Q00000X
-----------------------------------------------------
Taxonomy Name | Clinic/Center
-----------------------------------------------------
License Number | 096044
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------