Healthcare Provider Details

I. General information

NPI: 1851435473
Provider Name (Legal Business Name): SHRINERS HOSPITALS FOR CHILDREN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2007
Last Update Date: 02/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 RICHMOND RD
LEXINGTON KY
40502-1204
US

IV. Provider business mailing address

PO BOX 8500 LOCKBOX #7462
PHILADELPHIA PA
19178-7642
US

V. Phone/Fax

Practice location:
  • Phone: 859-266-2101
  • Fax: 859-268-5636
Mailing address:
  • Phone: 859-266-2101
  • Fax: 859-268-5636

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number100116
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. TONY LEWGOOD
Title or Position: ADMINISTRATOR
Credential:
Phone: 859-268-5630