1851631709 NPI number — SHRINERS HOSPITALS FOR CHILDREN

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851631709 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:
1851631709
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/05/2023
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:
813-281-8478
Provider Business Mailing Address Fax Number:
813-281-8113

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
815 MARKET ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GALVESTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77550-2725
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
409-770-6600
Provider Business Practice Location Address Fax Number:
409-770-6977
Provider Enumeration Date:
02/28/2013

Additional Information

Authorized Official

Authorized Official Last Name:
GANTT
Authorized Official First Name:
JERRY
Authorized Official Middle Name:
G.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
813-281-0300

Provider Taxonomy Codes

  • Taxonomy code: 2086S0120X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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