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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
1207XP3100XPediatric Orthopaedic Surgery Physician

General Provider Information

NPI Number : 1396187282
Entity Type Code : Organization
Provider Name (Legal Business Name) : SHRINERS HOSPITALS FOR CHILDREN
Provider Business Mailing Address
First Line : PO BOX 8500
Second Line : LOCKBOX #7642
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 E 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 : ADMINISTRATOR
Name : KEVIN CRAIG MARTIN
Credential :
Telephone Number : 801-536-3700
Provider Enumeration Date : 07/22/2013
Last Update Date : 05/20/2014

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