Basic Information
| Provider Information | |||||||||
| NPI: | 1669513941 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SHRINERS HOSPITALS FOR CHILDREN | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 8500 | ||||||||
| Address2: | LOCKBOX #7642 | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191787642 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8132818478 | ||||||||
| FaxNumber: | 8132818113 | ||||||||
| Practice Location | |||||||||
| Address1: | 815 MARKET STREET | ||||||||
| Address2: | |||||||||
| City: | GALVESTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 77550 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4097706600 | ||||||||
| FaxNumber: | 4097706977 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/09/2007 | ||||||||
| LastUpdateDate: | 09/10/2012 | ||||||||
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| AuthorizedOfficialLastName: | FERRELL | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
| AuthorizedOfficialMiddleName: | A. | ||||||||
| AuthorizedOfficialTitleorPosition: | REGIONAL ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 4097706771 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282NC2000X | 000247 | TX | Y | Hospitals | General Acute Care Hospital | Children |
No ID Information.