Organization
CHILDREN'S HOSPITAL MEDICAL CENTER
Active
Parent organization
CHILDREN'S HOSPITAL MEDICAL CENTER
Other names
Children's Hospital Medical Center - Home Health IV Therapy 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
660 LINCOLN AVE, CINCINNATI, OH 45206-1100
(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
3336H0001X
Home Infusion Therapy Pharmacy
Primary
02-1346100
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0173998002
—
WV
05
—
0173998003
—
WV
01
—
02-1346100
PHARMACY LICENSE
OH
05
—
2800044
—
OH
05
—
315488200
—
MN
01
—
3671193
NCPDP
—
05
—
7100001090
—
KY
01
—
720040
LICENSE
KY
Enumeration date
02/02/2007
Last updated
03/07/2023
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