Provider Demographics
NPI:1063480721
Name:BAPTIST ST. ANTHONY'S HOSPITAL CORPORATION
Entity Type:Organization
Organization Name:BAPTIST ST. ANTHONY'S HOSPITAL CORPORATION
Other - Org Name:BAPTIST ST. ANTHONY'S HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:PULLIAM
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:806-212-5170
Mailing Address - Street 1:1600 WALLACE BLVD
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-1799
Mailing Address - Country:US
Mailing Address - Phone:806-212-2000
Mailing Address - Fax:
Practice Address - Street 1:721 N TAYLOR
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79107-5279
Practice Address - Country:US
Practice Address - Phone:806-212-7500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAPTIST ST. ANTHONY'S HEALTH SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-03-09
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX003358251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXHH9618OtherBLUE CROSS
TX5631271OtherAETNA
TX5631271OtherAETNA
TX=========OtherCIGNA
TX45-8292Medicare ID - Type UnspecifiedHOME HELATH AGENCY