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General NPI Number Information
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NPI Number | 1295407815
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Entity Type | Organization
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Legal Business Name | SHRINERS HOSPITALS FOR CHILDREN
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Dates
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Enumeration Date | 10/01/2021
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Last Update Date | 10/01/2021
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Provider Practice Location Address
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Address Line | 750 MURPHY RD
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City | MEDFORD
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State | OR
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Zip | 97504-8426
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Country | US
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Telephone | 503-396-9148
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Fax | 503-221-3701
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Provider Business Mailing Address
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Address Line | PO BOX 8500 LOCKBOX 7642
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City | PHILADELPHIA
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State | PA
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Zip | 19178-7642
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Country | US
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Telephone | 813-281-0300
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Fax | 813-281-0943
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JERRY G. GANTT
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Credential |
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Telephone | 813-281-0300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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