Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Children |
282NC2000X | A0[7] | Hospital-Children’s (PPS excluded) | |
Health Maintenance Organization |
302R00000X | |||
Nursing Care |
251J00000X | |||
Nursing Facility/Intermediate Care Facility |
313M00000X | A3[10] | Other Nursing Facility | |
Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
320600000X |
| NPI Number | 1982093944 |
||||
| LBN Legal business name | FAMILY PEDIATRIC | ||||
| Authorized official | OLUWAKEMI OGUNDALU - (REGISTERED NURSE) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 01/14/2015 | ||||
| Last updated | 01/14/2015 - About 11 years ago | ||||
| Identifiers |
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