1699770149 NPI number — MUENSTER HOSPITAL DISTRICT

Table of content: (NPI 1699770149)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699770149 NPI number — MUENSTER HOSPITAL DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MUENSTER 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:
MUENSTER MEMORIAL 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:
1699770149
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/17/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 370
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MUENSTER
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76252-0370
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
940-759-2271
Provider Business Mailing Address Fax Number:
940-759-5080

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
605 N MAPLE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MUENSTER
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76252-2424
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
940-759-2271
Provider Business Practice Location Address Fax Number:
940-759-5080
Provider Enumeration Date:
06/20/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ROLAND
Authorized Official First Name:
BRIAN
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
940-759-6153

Provider Taxonomy Codes

  • Taxonomy code: 282NC0060X , with the licence number:  000365 , 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: HH0563 . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 120745806 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".