MEDICARE: SHRINERS HOSPITALS FOR CHILDREN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist
2	282NC2000X	Children's Hospital	100116	KY

General Provider Information

NPI Number	:	1851435473
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHRINERS HOSPITALS FOR CHILDREN

Provider Business Mailing Address
First Line	:	PO BOX 8500
Second Line	:	LOCKBOX #7462
City	:	PHILADELPHIA
State	:	PA
Zip	:	19178-7642
Country	:	US
Telephone Number	:	859-266-2101
Fax Number	:	859-268-5636

Provider Business Practice Location Address
First Line	:	1900 RICHMOND RD
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40502-1204
Country	:	US
Telephone Number	:	859-266-2101
Fax Number	:	859-268-5636

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. TONY LEWGOOD
Credential	:
Telephone Number	:	859-268-5630

Provider Enumeration Date	:	02/16/2007
Last Update Date	:	02/25/2013

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