Provider Demographics
NPI:1932448115
Name:SHRINERS HOSPITALS FOR CHILDREN
Entity Type:Organization
Organization Name:SHRINERS HOSPITALS FOR CHILDREN
Other - Org Name:SHRINERS HOSPITALS FOR CHILDREN PROFESSIONAL SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:
Authorized Official - Last Name:RAYNAUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-941-4466
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:808-941-4466
Mailing Address - Fax:
Practice Address - Street 1:1310 PUNAHOU ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-1027
Practice Address - Country:US
Practice Address - Phone:808-941-4466
Practice Address - Fax:808-942-8573
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SHRINERS HOSPITALS FOR CHILDREN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-02-07
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI8-H282NC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI684804Medicaid
HI684804Medicaid