Basic Information
Provider Information
NPI: 1932448248
EntityType: 2
ReplacementNPI:  
OrganizationName: NATIONWIDE CHILDRENS HOSPITAL
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 700 CHILDRENS DRIVE
Address2: NATIONWIDE CHILDRENS HOSPITAL
City: COLUMBUS
State: OH
PostalCode: 432050000
CountryCode: US
TelephoneNumber: 6147222000
FaxNumber:  
Practice Location
Address1: 700 CHILDREN'S DRIVE
Address2: NATIONWIDE CHILDRENS HOSPITAL
City: COLUMBUS
State: OH
PostalCode: 432052664
CountryCode: US
TelephoneNumber: 6147222000
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/06/2013
LastUpdateDate: 02/06/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: THOMAS
AuthorizedOfficialFirstName: OLIVIA
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: DIVISION CHIEF
AuthorizedOfficialTelephone: 6147224950
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: M.D
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QU0200X096044OHN Ambulatory Health Care FacilitiesClinic/CenterUrgent Care
261Q00000X096044OHY Ambulatory Health Care FacilitiesClinic/Center 

No ID Information.


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