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NPI Code Detail

MEDICARE: SHRINERS HOSPITALS FOR CHILDREN

MEDICARE: SHRINERS HOSPITALS FOR CHILDREN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1282NC2000XChildren's Hospital2005-HOSP-2006UT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12005-HOSP-206OTHERUTSTATE FACILITY LICENSE

General Provider Information

NPI Number : 1255461075
Entity Type Code : Organization
Provider Name (Legal Business Name) : SHRINERS HOSPITALS FOR CHILDREN
Provider Business Mailing Address
First Line : SHRINERS HOSPITAL FOR CHILDREN SALT
Second Line : P.O. BOX 8500 LOCKBOX #7462
City : PHILADELPHIA
State : PA
Zip : 19178-7642
Country : US
Telephone Number : 801-536-3714
Fax Number : 801-536-3799
Provider Business Practice Location Address
First Line : 1275 FAIRFAX RD
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84103-4324
Country : US
Telephone Number : 801-536-3714
Fax Number : 801-536-3799
Authorized Official
Title or Position : HOSPITAL ADMINISTRATOR
Name : KEVIN CRAIG MARTIN
Credential :
Telephone Number : 801-536-3700
Provider Enumeration Date : 03/07/2007
Last Update Date : 10/25/2012

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Directions to “SHRINERS HOSPITALS FOR CHILDREN ” Practice Location

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