1437218062 NPI number — MONTGOMERY COUNTY HOSPITAL DISTRICT

Table of content: (NPI 1437218062)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437218062 NPI number — MONTGOMERY COUNTY HOSPITAL DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MONTGOMERY 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:
MCHD-EMS
Provider Other Organization Name Type Code:
5
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:
1437218062
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/24/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2587
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CONROE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77305-2587
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
936-523-1128
Provider Business Mailing Address Fax Number:
936-539-2766

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1400 SOUTH LOOP 336 WEST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CONROE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77304-3504
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
936-523-1128
Provider Business Practice Location Address Fax Number:
936-539-2766
Provider Enumeration Date:
12/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WEBB
Authorized Official First Name:
KAREN
Authorized Official Middle Name:
RITA
Authorized Official Title or Position:
BILLING MANAGER
Authorized Official Telephone Number:
936-523-1128

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  300189 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 47240 . This is a "HMO BLUE STAR PLUS 81053" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: XMTE06119 . This is a "CAID SAN MATEO CA" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 0070831 . This is a "BC BS OF TN 180150" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 296743 . This is a "BC BS OF PA 898845" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 300189 . This is a "ESIS 419310" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 41527 . This is a "CHIPS AMERIKIDS 62947" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 107752101 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 590006512 . This is a "RR MCARE 10066" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: AMB300189 . This is a "TEXAS MUTUAL 841843" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 300128 . This is a "TEXAS MUTUAL 12029" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1014892 . This is a "AETNA 1125" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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