Provider Demographics
NPI:1114599503
Name:EL CAMPO MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:EL CAMPO MEMORIAL HOSPITAL
Other - Org Name:MIDCOAST PHARMACY#1
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-942-3584
Mailing Address - Street 1:303 SANDY CORNER RD
Mailing Address - Street 2:
Mailing Address - City:EL CAMPO
Mailing Address - State:TX
Mailing Address - Zip Code:77437-9535
Mailing Address - Country:US
Mailing Address - Phone:979-578-5250
Mailing Address - Fax:
Practice Address - Street 1:1201 N MECHANIC ST
Practice Address - Street 2:
Practice Address - City:EL CAMPO
Practice Address - State:TX
Practice Address - Zip Code:77437-2613
Practice Address - Country:US
Practice Address - Phone:979-942-3584
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EL CAMPO MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-07-14
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy