1861542235 NPI number — CHAMBERS COUNTY PUBLIC HOSPITAL DISTRICT NO 1

Table of content: (NPI 1861542235)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861542235 NPI number — CHAMBERS COUNTY PUBLIC HOSPITAL DISTRICT NO 1

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHAMBERS COUNTY PUBLIC HOSPITAL DISTRICT NO 1
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:
OMNI POINT HEALTH
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:
1861542235
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/10/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 398
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ANAHUAC
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77514-0398
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
409-267-3143
Provider Business Mailing Address Fax Number:
409-267-3608

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 HOSPITAL DR.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANAHUAC
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77514-0398
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
409-267-3143
Provider Business Practice Location Address Fax Number:
409-267-3608
Provider Enumeration Date:
01/10/2007

Additional Information

Authorized Official

Authorized Official Last Name:
PASCASIO
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
409-267-3143

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 367500000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 00C25L . This is a "BCBS CRNA PRO FEES" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 112504901 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0005356055 . This is a "AETNA NON HMO ER-PR FEES" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 127254404 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0002556037 . This is a "AETNA HMO ALL" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 0007414307 . This is a "AETNA NON HMO WCMC" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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