1992050009 NPI number — NATIONWIDE CHILDREN'S HOSPITAL, INC

Table of content: (NPI 1992050009)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992050009 NPI number — NATIONWIDE CHILDREN'S HOSPITAL, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NATIONWIDE CHILDREN'S HOSPITAL, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
NATIONWIDE CHILDREN'S HOSPITAL BEHAVIORAL HEALTH SERVICES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1992050009
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/27/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
255 E MAIN ST
Provider Second Line Business Mailing Address:
3RD FLOOR
Provider Business Mailing Address City Name:
COLUMBUS
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43215-5222
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-355-0511
Provider Business Mailing Address Fax Number:
614-355-0509

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
399 E MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43215-5384
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-355-8550
Provider Business Practice Location Address Fax Number:
614-355-8593
Provider Enumeration Date:
07/16/2012

Additional Information

Authorized Official

Authorized Official Last Name:
HOFFMAN
Authorized Official First Name:
AILEEN
Authorized Official Middle Name:
P.
Authorized Official Title or Position:
BEHAVIORAL HEALTH OPERATIONS MANAGE
Authorized Official Telephone Number:
614-355-0511

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QM0801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM0855X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 08258 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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