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General NPI Number Information
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NPI Number | 1033112230
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Entity Type | Organization
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Legal Business Name | ST JUDE CHILDRENS RESEARCH HOSPITAL INC
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Dates
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Enumeration Date | 05/23/2005
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Last Update Date | 09/12/2018
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Provider Practice Location Address
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Address Line | 262 DANNY THOMAS PL
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City | MEMPHIS
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State | TN
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Zip | 38105-3678
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Country | US
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Telephone | 901-595-3300
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Fax |
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Provider Business Mailing Address
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Address Line | 262 DANNY THOMAS PLACE MS 0515 ST JUDE CHILDRENS RESEARCH HOSPITAL
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City | MEMPHIS
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State | TN
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Zip | 38105-3678
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Country | US
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Telephone | 901-595-6863
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Fax | 901-595-3842
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Authorized Official
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Title or Position | SVP/CFO
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Name | PATRICIA A. KEEL
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Credential |
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Telephone | 901-595-2916
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number | 843
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 282NC2000X
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Taxonomy Name | Children's Hospital
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License Number | 0000000113
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License Number State | TN
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