Provider Demographics
NPI:1275666471
Name:CHILD HEALTH SYSTEMS INC
Entity Type:Organization
Organization Name:CHILD HEALTH SYSTEMS INC
Other - Org Name:PRESCRIBED PEDIATRIC EXTENDED CARE PEDIATRIC HEALTH CHOICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:HUONG
Authorized Official - Middle Name:L
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-880-0220
Mailing Address - Street 1:8509 BENJAMIN ROAD
Mailing Address - Street 2:SUITE A D
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-1224
Mailing Address - Country:US
Mailing Address - Phone:813-880-0220
Mailing Address - Fax:813-880-0221
Practice Address - Street 1:8509 BENJAMIN ROAD
Practice Address - Street 2:SUITE A D
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-1224
Practice Address - Country:US
Practice Address - Phone:813-880-0220
Practice Address - Fax:813-880-0221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH12832333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy