1669513941 NPI number — SHRINERS HOSPITALS FOR CHILDREN

Table of content: (NPI 1669513941)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669513941 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:
Provider Other Organization Name Type Code:
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:
1669513941
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/10/2012
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 STREET
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
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:
02/09/2007

Additional Information

Authorized Official

Authorized Official Last Name:
FERRELL
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
A.
Authorized Official Title or Position:
REGIONAL ADMINISTRATOR
Authorized Official Telephone Number:
409-770-6771

Provider Taxonomy Codes

  • Taxonomy code: 282NC2000X , with the licence number:  000247 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 119106500 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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