Healthcare Provider Details
I. General information
NPI: 1568299857
Provider Name (Legal Business Name): SHRINERS HOSPITALS FOR CHILDREN
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/19/2024
Last Update Date: 01/10/2025
Certification Date: 01/10/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
98-1247 KAAHUMANU ST STE 122
AIEA HI
96701-5300
US
IV. Provider business mailing address
PO BOX 8500 LOCKBOX #7642
PHILADELPHIA PA
19178-7642
US
V. Phone/Fax
- Phone: 808-941-4466
- Fax: 808-951-3707
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOHN
P.
MCCABE
Title or Position: EXECUTIVE VICE PRESIDENT
Credential:
Phone: 813-281-0300