1023011657 NPI number — SWEENY HOSPITAL DISTRICT

Table of content: (NPI 1023011657)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023011657 NPI number — SWEENY HOSPITAL DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SWEENY 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:
SWEENY COMMUNITY 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:
1023011657
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/19/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
305 N MCKINNEY ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SWEENY
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77480-2801
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
979-548-1500
Provider Business Mailing Address Fax Number:
979-548-1595

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
305 N MCKINNEY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SWEENY
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77480-2801
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
979-548-1500
Provider Business Practice Location Address Fax Number:
979-548-1595
Provider Enumeration Date:
05/27/2005

Additional Information

Authorized Official

Authorized Official Last Name:
BURGE
Authorized Official First Name:
CINDY
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATIVE ASSISTANT/CREDENTIAL
Authorized Official Telephone Number:
979-548-1598

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207LP2900X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207P00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 275N00000X , with the licence number: 000178 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 282NC0060X , with the licence number: 000178 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3416L0300X , with the licence number: 020037 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363A00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 1370736-12 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0209884-01 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1370736-04 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0133118-01 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1370736-13 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0209884-02 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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