Provider Demographics
NPI:1942343447
Name:SHRINERS HOSPITALS FOR CHILDREN
Entity Type:Organization
Organization Name:SHRINERS HOSPITALS FOR CHILDREN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:GLOSS
Authorized Official - Suffix:
Authorized Official - Credentials:FACHE
Authorized Official - Phone:314-432-3600
Mailing Address - Street 1:PO BOX 8500
Mailing Address - Street 2:LOCKBOX #7642
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-7642
Mailing Address - Country:US
Mailing Address - Phone:813-281-8478
Mailing Address - Fax:813-281-8113
Practice Address - Street 1:4400 CLAYTON AVENUE
Practice Address - Street 2:
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1624
Practice Address - Country:US
Practice Address - Phone:314-432-3600
Practice Address - Fax:314-432-2930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO142-53282NC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren