MEMORIAL MEDICAL CLINIC NPI 1578960647

NPI Information

NPI: 1578960647
Provider Name: MEMORIAL MEDICAL CLINIC
Classification: General Acute Care Hospital - 282NC0060X
Entity Type: Organization

Specialization: Critical Access

Address:
815 N VIRGINIA ST
PORT LAVACA, TX
ZIP 77979
Phone: (361) 552-0224
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MEMORIAL MEDICAL CLINIC is a critical access general acute care hospital in Port Lavaca, TX. MEMORIAL MEDICAL CLINIC NPI is 1578960647. The provider is registered as an organization entity type.

The provider's business location address is:

815 N VIRGINIA ST
PORT LAVACA, TX
ZIP 77979-025
Phone: (361) 552-0224
Fax: (361) 552-0220

The provider's authorized official is Diane Chris Moore .
The authorized official title is Cfo and has the following contact phone number (361) 552-0224.

The enumeration date for this NPI number is 12/4/2014 and was last updated on 12/4/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	282NC0060X	General Acute Care Hospital	Critical Access	000487	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	137909111	MEDICAID	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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