Basic Information
| Provider Information | |||||||||
| NPI: | 1417697590 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | EL CAMPO MEMORIAL HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 25000 US HWY 59 | ||||||||
| Address2: | |||||||||
| City: | BAY CITY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774148457 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9799423584 | ||||||||
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| Practice Location | |||||||||
| Address1: | 25000 US HWY 59 | ||||||||
| Address2: | |||||||||
| City: | BAY CITY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774148457 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9799423584 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/29/2022 | ||||||||
| LastUpdateDate: | 03/29/2022 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | SMITH | ||||||||
| AuthorizedOfficialFirstName: | MELISSA | ||||||||
| AuthorizedOfficialMiddleName: | ANN | ||||||||
| AuthorizedOfficialTitleorPosition: | PHARMACY TECHNICIAN | ||||||||
| AuthorizedOfficialTelephone: | 9799423584 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | EL CAMPO MEMORIAL HOSPITAL | ||||||||
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| NPICertificationDate: | 03/17/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 333600000X | Y | Suppliers | Pharmacy |
No ID Information.