Organization
SHRINERS HOSPITALS FOR CHILDREN
Active
Organization
SHRINERS HOSPITALS FOR CHILDREN
Active
Other names
Shriners Hospitals for Children Professional Services
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY G. GANTT (PRESIDENT)
(813) 281-0300
Entity
Organization
Contact information
Practice address
950 W FARIS RD, GREENVILLE, SC 29605-4255
(864) 271-3444
(864) 271-4471
Mailing address
PO BOX 8500, LOCKBOX #7642, PHILADELPHIA, PA 19178-7642
(864) 271-3444
(864) 271-4471
Taxonomy
Speciality
Code
Description
License number
State
207XP3100X
Pediatric Orthopaedic Surgery Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
06/03/2013
Last updated
01/13/2023
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