Provider Demographics
NPI:1053464305
Name:CHMC COMMUNITY HEALTH SERVICES NETWORK
Entity Type:Organization
Organization Name:CHMC COMMUNITY HEALTH SERVICES NETWORK
Other - Org Name:CHILDREN'S HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR MEDICAL STAFF SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:E
Authorized Official - Last Name:GUTHRIE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CPMSM, CPCS
Authorized Official - Phone:513-636-9691
Mailing Address - Street 1:3333 BURNET AVENUE ML 5021
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3026
Mailing Address - Country:US
Mailing Address - Phone:513-636-4225
Mailing Address - Fax:513-636-2511
Practice Address - Street 1:124 STATE ROAD 46 WEST
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:IN
Practice Address - Zip Code:47006-1487
Practice Address - Country:US
Practice Address - Phone:812-933-6000
Practice Address - Fax:812-933-6013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200122080AMedicaid
OH0264271Medicaid