NPIViewer - Provider NPI 1316931090

NPI:	1316931090
Name:	CHILD HEALTH SYSTEMS INC
Entity type:	Organization
Organization Name:	CHILD HEALTH SYSTEMS INC
Other - Org Name:	<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:	PRESIDENT
Authorized Official - Prefix:	MR
Authorized Official - First Name:	STEPHEN
Authorized Official - Middle Name:	T
Authorized Official - Last Name:	BARRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:	813-880-0220
Mailing Address - Street 1:	8509 BENJAMIN RD
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 RD
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:	2005-09-08
Last Update Date:	2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:

Primary?	Code	Type	Classification	Specialization
Yes	332B00000X	Suppliers	Durable Medical Equipment & Medical Supplies

State	Identifier ID	ID Type
FL	240012000	Medicaid
FL	880567902	Medicaid
FL	882377400	Medicaid
FL	240005700	Medicaid
FL	650311001	Medicaid
FL	950888100	Medicaid
FL	300003604	Medicaid
FL	300047800	Medicaid
FL	300256001	Medicaid
FL	880567901	Medicaid
FL	650311000	Medicaid
FL	880567904	Medicaid
FL	300003600	Medicaid
FL	300256000	Medicaid
FL	102745000	Medicaid
FL	300003601	Medicaid
FL	880567903	Medicaid
FL	950752300	Medicaid
FL	950752301	Medicaid
FL	300003603	Medicaid