1023063914 NPI number — EL PASO HEALTHCARE SYSTEM LTD

Table of content: (NPI 1023063914)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023063914 NPI number — EL PASO HEALTHCARE SYSTEM LTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EL PASO HEALTHCARE SYSTEM LTD
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:
LAS PALMAS DEL SOL HEALTHCARE
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:
1023063914
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/02/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10301 GATEWAY BLVD W
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EL PASO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79925-7701
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
915-595-9000
Provider Business Mailing Address Fax Number:
915-595-7224

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10301 GATEWAY BLVD W
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EL PASO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79925-7701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
915-595-9000
Provider Business Practice Location Address Fax Number:
915-595-7224
Provider Enumeration Date:
05/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HAYS
Authorized Official First Name:
MICHELLE
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
915-521-1670

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: 000910863X , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 003121150 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100104530A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3008281 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 171715 , issued by the state of ( OR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1760391 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: A5115 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
  • Identifier: 117514105 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 177038500 . This is a "DEPT OF LABOR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 94188201 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100751510000 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4500646 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 013359401 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0574939 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: XHSP30188 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010031095 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 01544816 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0450646 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200470840A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7000316 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".




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