Provider Demographics
NPI:1093783565
Name:NORTHWEST COMMUNITY HEALTH, INC
Entity Type:Organization
Organization Name:NORTHWEST COMMUNITY HEALTH, INC
Other - Org Name:NORTHWEST RURAL EMERGENCY MEDICAL SERVICES ASSOCIATION
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:BAYANI
Authorized Official - Suffix:
Authorized Official - Credentials:LP
Authorized Official - Phone:281-351-8272
Mailing Address - Street 1:29530 QUINN RD
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375
Mailing Address - Country:US
Mailing Address - Phone:281-351-8272
Mailing Address - Fax:281-357-4524
Practice Address - Street 1:29530 QUINN RD
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375
Practice Address - Country:US
Practice Address - Phone:281-351-8272
Practice Address - Fax:281-357-4524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX341600000X, 3416L0300X
TX1010213416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1635812Medicaid
TX000202401Medicaid
590001712Medicare ID - Type UnspecifiedRAILROAD
TX000202401Medicaid
B27605Medicare UPIN