1649200601 NPI number — CGH HOSPITAL, LTD.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649200601 NPI number — CGH HOSPITAL, LTD.

Employer Identification Number (EIN):

Provider Organization Name:

CGH HOSPITAL, LTD.

Provider Last Name:

Provider First Name:

Provider Middle Name:

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

Provider Gender Code:

Provider Other Organization Name:

CORAL GABLES 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:

1649200601

Entity Type Code:

Organization

Replacement NPI:

Last Update Date:

08/17/2022

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

PO BOX 741215

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

ATLANTA

Provider Business Mailing Address State Name:

GA

Provider Business Mailing Address Postal Code:

30374-1215

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

561-982-2189

Provider Business Mailing Address Fax Number:

305-441-6879

Provider First Line Business Practice Location Address:

3100 DOUGLAS RD

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

CORAL GABLES

Provider Business Practice Location Address State Name:

FL

Provider Business Practice Location Address Postal Code:

33134-6914

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

305-445-8461

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:

07/04/2006

Authorized Official Last Name:

ARMIN

Authorized Official First Name:

CRAIG

Authorized Official Middle Name:

C.

Authorized Official Title or Position:

VP OF GOVT PROGRAMS, TENET

Authorized Official Telephone Number:

818-436-2267

• Taxonomy code: 261Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 282N00000X , with the licence number: 4200 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 100183B000000 . This is a "SECTION 1011" identifier . This identifiers is of the category "OTHER".
• Identifier: 20044 . This is a "WELL CARE/STAYWELL/HEALT" identifier . This identifiers is of the category "OTHER".
• Identifier: 237152 . This is a "AVMED" identifier . This identifiers is of the category "OTHER".
• Identifier: 269299 . This is a "COVENTRY HEALTH CARE LOUI" identifier . This identifiers is of the category "OTHER".
• Identifier: SECTION 1011 . This is a "NHP MCR 1000" identifier . This identifiers is of the category "OTHER".
• Identifier: 1002900 . This is a "CARE PLUS" identifier . This identifiers is of the category "OTHER".
• Identifier: 080097 . This is a "HUMANA" identifier . This identifiers is of the category "OTHER".
• Identifier: 10960600 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
• Identifier: 265 . This is a "BCBS OF FLORIDA" identifier . This identifiers is of the category "OTHER".
• Identifier: 990037 . This is a "NEIGHBORHOOD HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
• Identifier: 741802680 . This is a "AMERIGROUP" identifier . This identifiers is of the category "OTHER".
• Identifier: 169983900 . This is a "US DEPT OF LABOR" identifier . This identifiers is of the category "OTHER".
• Identifier: 491047360 . This is a "AETNA US HEALTHCARE (NATI" identifier . This identifiers is of the category "OTHER".