Provider Demographics
NPI:1831766476
Name:CHILDREN'S HOSPITAL OF ORANGE
Entity type:Organization
Organization Name:CHILDREN'S HOSPITAL OF ORANGE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXEC. VP AND CFO
Authorized Official - Prefix:
Authorized Official - First Name:KERRI
Authorized Official - Middle Name:RUPPERT
Authorized Official - Last Name:SCHILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-509-8451
Mailing Address - Street 1:1201 W LA VETA AVE STE B224
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4203
Mailing Address - Country:US
Mailing Address - Phone:877-794-2462
Mailing Address - Fax:
Practice Address - Street 1:1201 W LA VETA AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4203
Practice Address - Country:US
Practice Address - Phone:877-794-2462
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHILDREN'S HOSPITAL OF ORANGE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-06-10
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
Yes3336C0003XSuppliersPharmacyCommunity/Retail PharmacyGroup - Single Specialty
No3336C0002XSuppliersPharmacyClinic Pharmacy