Basic Information
| Provider Information | |||||||||
| NPI: | 1689621450 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | OSCEOLA REGIONAL HOSPITAL, INC. | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | HCA FLORIDA OSCEOLA HOSPITAL | ||||||||
| OtherOrganizationType: | 3 | ||||||||
| OtherLastName: | |||||||||
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| OtherCredential: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 700 W OAK ST | ||||||||
| Address2: | |||||||||
| City: | KISSIMMEE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 347414924 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4078462266 | ||||||||
| FaxNumber: | 4075183616 | ||||||||
| Practice Location | |||||||||
| Address1: | 700 W OAK ST | ||||||||
| Address2: | |||||||||
| City: | KISSIMMEE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 347414924 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4078462266 | ||||||||
| FaxNumber: | 4075183616 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/27/2006 | ||||||||
| LastUpdateDate: | 08/09/2022 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | BIGGAR | ||||||||
| AuthorizedOfficialFirstName: | CARRIE | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 4075183603 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 08/09/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | Y | Hospitals | General Acute Care Hospital |
ID Information
| ID | Type | State | Issuer | Description | 001574740003 | 05 | PA | MEDICAID | 100697350A | 05 | WI | MEDICAID | 7205163 | 05 | MA | MEDICAID | HOS0110N | 05 | AL | MEDICAID | HS42IP | 05 | AK | MEDICAID | 13888706 | 05 | MO | MEDICAID | 200163940 | 05 | IN | MEDICAID | 67320 | 01 | AMERIGROUP | OTHER | 95019337 | 05 | CO | MEDICAID | 100110 | 05 | NC | MEDICAID | 0235650 | 05 | OH | MEDICAID | 108699302 | 05 | TX | MEDICAID | 30-3219885 | 05 | MI | MEDICAID | 000621717X | 05 | GA | MEDICAID | 0100110 | 05 | VT | MEDICAID | 01291962 | 05 | KY | MEDICAID | 089008 | 01 | AVMED | OTHER | 1189268 | 05 | NV | MEDICAID | 136670105 | 05 | AR | MEDICAID | 1765961 | 05 | LA | MEDICAID | 01019552 | 05 | NY | MEDICAID | 10138900 | 05 | FL | MEDICAID | 338 | 01 | BLUE CROSS | OTHER | XHSP32720 | 05 | CA | MEDICAID | 003102241 | 05 | CT | MEDICAID | 0186932501 | 05 | KS | MEDICAID | 013523200 | 05 | MN | MEDICAID | 20001866 | 05 | NH | MEDICAID | 525305 | 05 | AZ | MEDICAID |