Organization
CHILDREN'S HOSPITAL MEDICAL CENTER
Active
Parent organization
CHILDREN'S HOSPITAL MEDICAL CENTER
Other names
Children's Hospital Medical Center - Retail Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHILDREN'S HOSPITAL MEDICAL CENTER
Authorized official
MRS. JODIANNE BROOMALL (SR DIRECTOR BILLING & CODING SERV)
(513) 636-5047
Entity
Organization
Contact information
Practice address
3333 BURNET AVENUE, CINCINNATI, OH 45229-3039
(513) 636-4225
(513) 636-2511
Mailing address
3337 SOLUTIONS CENTER, BOX 773337, CHICAGO, IL 60677-3003
(513) 636-4225
(513) 636-2511
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
02-0040400
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0173998003
—
WV
01
—
02-32000233
LICENSE
OH
05
—
200046400A
—
IN
05
—
2800017
—
OH
01
—
3629219
NCPDP
—
05
—
54021670
—
KY
Enumeration date
02/02/2007
Last updated
03/07/2023
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