Provider Demographics
NPI:1316204027
Name:IMPERIAL HOSPITAL SUGAR LAND LLC
Entity Type:Organization
Organization Name:IMPERIAL HOSPITAL SUGAR LAND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAMPAGNE
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN
Authorized Official - Phone:281-788-1909
Mailing Address - Street 1:319 LAKE BEND DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-5801
Mailing Address - Country:US
Mailing Address - Phone:281-788-1909
Mailing Address - Fax:832-201-9200
Practice Address - Street 1:319 LAKE BEND DR
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-5801
Practice Address - Country:US
Practice Address - Phone:281-788-1909
Practice Address - Fax:832-201-9200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-19
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital