Healthcare Provider Details

I. General information

NPI: 1326187097
Provider Name (Legal Business Name): SHRINERS HOSPITALS FOR CHILDREN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 12/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 W FARIS RD
GREENVILLE SC
29605-4277
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 864-271-3444
  • Fax: 864-271-4471
Mailing address:
  • Phone: 813-281-8478
  • Fax: 813-281-8113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code284300000X
TaxonomySpecial Hospital
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License NumberHTL-0069
License Number StateSC

VIII. Authorized Official

Name: MR. RANDALL R. ROMBERGER
Title or Position: ADMINISTRATOR
Credential:
Phone: 864-271-3444