Provider Demographics
NPI:1144266693
Name:SHRINERS HOSPITALS FOR CHILDREN-A COLORADO CORPORATION
Entity type:Organization
Organization Name:SHRINERS HOSPITALS FOR CHILDREN-A COLORADO CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DPCS
Authorized Official - Prefix:
Authorized Official - First Name:CECILIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRIOS
Authorized Official - Suffix:
Authorized Official - Credentials:MN
Authorized Official - Phone:213-368-3350
Mailing Address - Street 1:3160 GENEVA ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-1117
Mailing Address - Country:US
Mailing Address - Phone:213-368-3340
Mailing Address - Fax:213-639-3435
Practice Address - Street 1:3160 GENEVA ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-1117
Practice Address - Country:US
Practice Address - Phone:213-368-3340
Practice Address - Fax:213-639-3435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0003X, 333600000X
CAHSP402633336I0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336I0012XSuppliersPharmacyInstitutional Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2065095OtherPK