Provider Demographics
| NPI: | 1023011657 |
|---|---|
| Name: | SWEENY HOSPITAL DISTRICT |
| Entity Type: | Organization |
| Organization Name: | SWEENY HOSPITAL DISTRICT |
| Other - Org Name: | SWEENY COMMUNITY HOSPITAL |
| Other - Org Type: | Doing Business As |
| Authorized Official - Title/Position: | ADMINISTRATIVE ASSISTANT/CREDENTIAL |
| Authorized Official - Prefix: | MRS |
| Authorized Official - First Name: | CINDY |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | BURGE |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 979-548-1598 |
| Mailing Address - Street 1: | 305 N MCKINNEY ST |
| Mailing Address - Street 2: | |
| Mailing Address - City: | SWEENY |
| Mailing Address - State: | TX |
| Mailing Address - Zip Code: | 77480-2801 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 979-548-1500 |
| Mailing Address - Fax: | 979-548-1595 |
| Practice Address - Street 1: | 305 N MCKINNEY ST |
| Practice Address - Street 2: | |
| Practice Address - City: | SWEENY |
| Practice Address - State: | TX |
| Practice Address - Zip Code: | 77480-2801 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 979-548-1500 |
| Practice Address - Fax: | 979-548-1595 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2005-05-27 |
| Last Update Date: | 2022-08-19 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| TX | 101YP2500X | |
| 207LP2900X, 207P00000X, 207Q00000X, 207R00000X, 225100000X, 225200000X, 363A00000X, 363L00000X | ||
| TX | 000178 | 275N00000X, 282NC0060X |
| TX | 020037 | 3416L0300X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 282NC0060X | Hospitals | General Acute Care Hospital | Critical Access | |
| No | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional | Group - Multi-Specialty |
| No | 207LP2900X | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | Group - Multi-Specialty |
| No | 207P00000X | Allopathic & Osteopathic Physicians | Emergency Medicine | Group - Multi-Specialty | |
| No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
| No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
| No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
| No | 225200000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant | Group - Multi-Specialty | |
| No | 275N00000X | Hospital Units | Medicare Defined Swing Bed Unit | Group - Multi-Specialty | |
| No | 3416L0300X | Transportation Services | Ambulance | Land Transport | Group - Multi-Specialty |
| No | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Group - Multi-Specialty | |
| No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| TX | 1370736-12 | Medicaid | |
| TX | 0209884-01 | Medicaid | |
| TX | 1370736-04 | Medicaid | |
| TX | 0133118-01 | Medicaid | |
| TX | 1370736-13 | Medicaid | |
| TX | 0209884-02 | Medicaid | |
| TX | 1370736-05 | Medicare PIN | |
| TX | 0133118-01 | Medicaid | |
| TX | 451311 | Medicare Oscar/Certification | |
| TX | AMB1145 | Medicare Oscar/Certification | |
| TX | 00802N | Medicare PIN | |
| TX | 0209884-01 | Medicaid | |
| TX | 0209884-02 | Medicaid | |
| TX | AMB1145 | Medicare PIN |
