1134172406 NPI number — COLUMBIA MEDICAL CENTER OF ARLINGTON SUBSIDIARY LP

Table of content: (NPI 1134172406)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134172406 NPI number — COLUMBIA MEDICAL CENTER OF ARLINGTON SUBSIDIARY LP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COLUMBIA MEDICAL CENTER OF ARLINGTON SUBSIDIARY LP
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:
MEDICAL CITY ARLINGTON
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:
1134172406
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/03/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3301 MATLOCK RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ARLINGTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76015-2908
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
817-465-3241
Provider Business Mailing Address Fax Number:
817-472-4878

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3301 MATLOCK RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARLINGTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76015-2908
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
817-465-3241
Provider Business Practice Location Address Fax Number:
817-472-4878
Provider Enumeration Date:
05/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ARDEMAGNI
Authorized Official First Name:
JEFF
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
817-472-4909

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: 0555599 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100364 , issued by the state of ( OR ) . This identifiers is of the category "MEDICAID".
  • Identifier: XHSP33592 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000953873X , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010333100 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0124030 , issued by the state of ( SD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100504252 , issued by the state of ( NV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200260770A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 401533900 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1001337 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1702340 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 37308777 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4500675 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: HOS0675N , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 015873904 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 203282400 . This is a "DEPT OF LABOR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4506758 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9073906 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 04458031 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100858965000 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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