Provider Demographics
NPI:1821185398
Name:CHILDREN'S HEALTH CENTER OF COLUMBUS, INC.
Entity Type:Organization
Organization Name:CHILDREN'S HEALTH CENTER OF COLUMBUS, INC.
Other - Org Name:CHILDREN'S HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SABRINA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MCDOW
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:662-329-2955
Mailing Address - Street 1:114 N LEHMBERG ROAD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:MS
Mailing Address - Zip Code:39702
Mailing Address - Country:US
Mailing Address - Phone:662-329-2955
Mailing Address - Fax:662-370-1236
Practice Address - Street 1:114 N LEHMBERG ROAD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39702
Practice Address - Country:US
Practice Address - Phone:662-329-2955
Practice Address - Fax:662-370-1236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS09014205Medicaid
AL529904270Medicaid