Organization
SHRINERS HOSPITALS FOR CHILDREN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY G. GANTT (PRESIDENT)
(813) 281-0300
Entity
Organization
Contact information
Practice address
3100 SAMFORD AVE, SUITE PT, SHREVEPORT, LA 71103-4239
(318) 222-5704
(318) 424-7610
Mailing address
PO BOX 8500 LOCKBOX #7642, PHILADELPHIA, PA 19178-7642
(813) 281-0300
(813) 281-0943
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
03/09/2022
Last updated
03/09/2022
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