EAST TEXAS MEDICAL CENTER SPECIALTY HOSPITAL
Long Term Care Hospital
Tyler, Texas
Provider NPI: 1619092780
Organization Information:Organization Name: EAST TEXAS MEDICAL CENTER SPECIALTY HOSPITAL
Practice Location:
1000 S BECKHAM AVE 5TH FLOOR TYLER, TX 75701 US
Tel: 903-596-3258 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
1000 S BECKHAM AVE 5TH FLOOR TYLER, TX 75701 US
Tel: 903-596-3258 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 282E00000X | Hospitals Long Term Care Hospital | TX | 000777 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
020812603 | TX | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin