Organization
SHRINERS HOSPITALS FOR CHILDREN
Active
Other names
Shriners Children's
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY G. GANTT (PRESIDENT)
(813) 281-0300
Entity
Organization
Contact information
Practice address
215 RADIO DR STE 100, WOODBURY, MN 55125-5817
(612) 596-6100
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
06/18/2020
Last updated
10/28/2021
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