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Organization
SHRINERS HOSPITALS FOR CHILDREN
Active
Organization
SHRINERS HOSPITALS FOR CHILDREN
Active
Other names
Shriners Hospitals for Children Rehabilitation Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY G. GANTT (PRESIDENT)
(813) 281-0300
Entity
Organization
Contact information
Practice address
1275 E FAIRFAX RD, SALT LAKE CITY, UT 84103-4324
(801) 536-3500
Mailing address
PO BOX 8500 LOCKBOX 7642, PHILADELPHIA, PA 19178-1435
(813) 281-0300
(813) 281-0943
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
06/25/2021
Last updated
06/25/2021
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