1346234093 NPI number — DALLAS COUNTY HOSPITAL DISTRICT

Table of content: (NPI 1346234093)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346234093 NPI number — DALLAS COUNTY HOSPITAL DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DALLAS COUNTY HOSPITAL DISTRICT
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
HATCHER STATION HEALTH CENTER PHARMACY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346234093
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/29/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5200 HARRY HINES BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75235-7709
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
469-419-1976
Provider Business Mailing Address Fax Number:
469-419-6210

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4600 SCYENE RD.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75246
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
469-419-1976
Provider Business Practice Location Address Fax Number:
469-419-6210
Provider Enumeration Date:
09/08/2005

Additional Information

Authorized Official

Authorized Official Last Name:
LOPEZ
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
S
Authorized Official Title or Position:
EXEC VP & CHIEF OPERATING OFFICER
Authorized Official Telephone Number:
214-590-4085

Provider Taxonomy Codes

  • Taxonomy code: 333600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 4586840 . This is a "NCPDP" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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