1639122864 NPI number — ENGLEWOOD COMMUNITY HOSPITAL, INC.

Table of content: (NPI 1639122864)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639122864 NPI number — ENGLEWOOD COMMUNITY HOSPITAL, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ENGLEWOOD COMMUNITY HOSPITAL, INC.
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:
HCA FLORIDA ENGLEWOOD HOSPITAL
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:
1639122864
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/30/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
700 MEDICAL BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ENGLEWOOD
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34223-3964
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
941-475-6571
Provider Business Mailing Address Fax Number:
941-473-5015

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
700 MEDICAL BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ENGLEWOOD
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34223-3964
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
941-475-6571
Provider Business Practice Location Address Fax Number:
941-473-5015
Provider Enumeration Date:
05/18/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MAGUREAN
Authorized Official First Name:
VICKIE
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
941-624-8122

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 404861509 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 20317 . This is a "WELLCARE/STAYWELL" identifier . This identifiers is of the category "OTHER".
  • Identifier: HOS0267N , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: '01637049 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0064724 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 010253900 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0918341 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200104800A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6106706 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 038013100 . This is a "BLACK LUNG" identifier . This identifiers is of the category "OTHER".
  • Identifier: 10906B , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 304861492 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 583 . This is a "BLUE CROSS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 000035952 . This is a "HUMANA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 010253900 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".