Healthcare Provider Details

I. General information

NPI: 1144266693
Provider Name (Legal Business Name): SHRINERS HOSPITALS FOR CHILDREN-A COLORADO CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 09/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3160 GENEVA ST
LOS ANGELES CA
90020-1117
US

IV. Provider business mailing address

3160 GENEVA ST
LOS ANGELES CA
90020-1117
US

V. Phone/Fax

Practice location:
  • Phone: 213-368-3340
  • Fax: 213-639-3435
Mailing address:
  • Phone: 213-368-3340
  • Fax: 213-639-3435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License NumberHSP40263
License Number StateCA

VIII. Authorized Official

Name: CECILIA BARRIOS
Title or Position: DPCS
Credential: MN
Phone: 213-368-3350