1578995528 NPI number — HARRISON COUNTY HOSPITAL ASSOCIATION

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578995528 NPI number — HARRISON COUNTY HOSPITAL ASSOCIATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HARRISON COUNTY HOSPITAL ASSOCIATION
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:
Provider Other Organization Name Type Code:
6
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:
1578995528
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/27/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1599
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MARSHALL
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75671-1599
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
903-927-6000
Provider Business Mailing Address Fax Number:
903-934-5172

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
304 UNIVERSITY AVE
Provider Second Line Business Practice Location Address:
SUITE 105
Provider Business Practice Location Address City Name:
MARSHALL
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75670-5210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
903-935-9441
Provider Business Practice Location Address Fax Number:
903-938-1246
Provider Enumeration Date:
08/01/2013

Additional Information

Authorized Official

Authorized Official Last Name:
COLLIER
Authorized Official First Name:
RUSSELL
Authorized Official Middle Name:
J.
Authorized Official Title or Position:
PRESIDENT / C.E.O.
Authorized Official Telephone Number:
903-927-6275

Provider Taxonomy Codes

  • Taxonomy code: 261QR1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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