# SHRINERS HOSPITALS FOR CHILDREN

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Shriners Hospitals for Children Professional Anesthesia Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528556776
- **Authorized official:** JERRY G. GANTT (PRESIDENT)
- **Authorized official phone:** (813) 281-0300

## Contact information

- **Practice address:** 1275 E FAIRFAX RD, SALT LAKE CITY, UT 84103
- **Practice address phone:** (801) 536-3500
- **Practice address fax:** (801) 536-3782
- **Mailing address:** PO BOX 8500 LOCKBOX \#7642, PHILADELPHIA, PA 19178-0001
- **Mailing address phone:** (813) 281-0300
- **Mailing address fax:** (813) 281-8113

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/24/2018
- **Last updated:** 05/24/2018