Provider Demographics
NPI:1164830907
Name:WESTBURY COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:WESTBURY COMMUNITY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:UM COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BENJETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:832-435-2382
Mailing Address - Street 1:5556 GASMER DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77035-4563
Mailing Address - Country:US
Mailing Address - Phone:832-435-2382
Mailing Address - Fax:
Practice Address - Street 1:5556 GASMER DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77035-4563
Practice Address - Country:US
Practice Address - Phone:832-435-2382
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-24
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization