1063466563 NPI number — NORTHWEST MEDICAL CENTER INC

Table of content: (NPI 1063466563)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063466563 NPI number — NORTHWEST MEDICAL CENTER INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTHWEST MEDICAL CENTER 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 NORTHWEST 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:
1063466563
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/01/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2801 N STATE ROAD 7
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MARGATE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33063-5727
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-974-0400
Provider Business Mailing Address Fax Number:
954-978-4183

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2801 N STATE ROAD 7
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MARGATE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33063-5727
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-974-0400
Provider Business Practice Location Address Fax Number:
954-978-4183
Provider Enumeration Date:
05/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PANIRY
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
786-315-5944

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: NOR0238N , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 404938669 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000030995 . This is a "HUMANA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 913828729A , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0021664 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 030009000 . This is a "BLACK LUNG" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0633550 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 304938650 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010459100 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 20817 . This is a "WELLCARE/STAYWELL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 267 . This is a "BLUE CROSS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 010459100 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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