1396187282 NPI number — SHRINERS HOSPITALS FOR CHILDREN

Table of content: (NPI 1396187282)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396187282 NPI number — SHRINERS HOSPITALS FOR CHILDREN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SHRINERS HOSPITALS FOR CHILDREN
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
SHRINERS HOSPITALS FOR CHILDREN (PROFESSIONAL SERVICES)
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1396187282
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/20/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 8500
Provider Second Line Business Mailing Address:
LOCKBOX #7642
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19178-7642
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
801-536-3714
Provider Business Mailing Address Fax Number:
801-536-3799

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1275 E FAIRFAX RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SALT LAKE CITY
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84103-4324
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-536-3714
Provider Business Practice Location Address Fax Number:
801-536-3799
Provider Enumeration Date:
07/22/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MARTIN
Authorized Official First Name:
KEVIN
Authorized Official Middle Name:
CRAIG
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
801-536-3700

Provider Taxonomy Codes

  • Taxonomy code: 207XP3100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)