Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
SHRINERS HOSPITALS FOR CHILDREN
Active
Organization
SHRINERS HOSPITALS FOR CHILDREN
Active
Other names
Shriners Hospitals for Children Shreveport
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARRY KIM GREEN FACHE (ADMINISTRATOR)
(318) 222-5704
Entity
Organization
Contact information
Practice address
3100 SAMFORD AVE, SHREVEPORT, LA 71103-4239
(318) 222-5704
(318) 424-7610
Mailing address
SHRINERS HOSPITALS FOR CHILDREN, P.O. BOX 8500, LOCKBOX #7642, PHILADELPHIA, PA 19178-7642
(813) 281-8657
(813) 281-8113
Taxonomy
Speciality
Code
Description
License number
State
282NC2000X
Children's Hospital
Primary
179
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08155267
—
MS
05
—
149229
—
AL
01
—
179
HOSPITAL LICENSE NUMBER
LA
05
—
191748105
—
AR
05
—
200341270A
—
OK
01
—
258361
MEDICARE PART B (PTAN)
LA
05
—
2700031
—
LA
05
—
3168429
—
TX
Enumeration date
02/19/2007
Last updated
03/07/2014
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up