1457358103 NPI number — BELLVILLE HOSPITAL DISTRICT

Table of content: (NPI 1457358103)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457358103 NPI number — BELLVILLE HOSPITAL DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BELLVILLE 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:
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:
1457358103
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/07/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
44 N CUMMINGS
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELLVILLE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77418-0977
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
979-865-3141
Provider Business Mailing Address Fax Number:
979-865-9631

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
44 N CUMMINGS
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELLVILLE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77418-0977
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
979-865-3141
Provider Business Practice Location Address Fax Number:
979-865-9631
Provider Enumeration Date:
07/07/2005

Additional Information

Authorized Official

Authorized Official Last Name:
MORRIS
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
M
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
979-865-3141

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X , with the licence number:  000552 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QA1903X , with the licence number: 552 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 275N00000X , with the licence number: 552 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 282N00000X , with the licence number: 000552 , 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: 083290904 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: HH0212 . This is a "BLUECROSS BLUESHIELD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: HH2448 . This is a "BCBS SWINGBED" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 0832909-06 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00J98X . This is a "BLUECROSS BLUESHIELD - ER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 0832909-05 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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