Provider Demographics
NPI:1336476845
Name:KIGLAPAIT HOSPITAL CORPORATION
Entity Type:Organization
Organization Name:KIGLAPAIT HOSPITAL CORPORATION
Other - Org Name:RENAISSANCE HOSPITAL GROVES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:WURSCHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-962-5733
Mailing Address - Street 1:5500 39TH ST
Mailing Address - Street 2:
Mailing Address - City:GROVES
Mailing Address - State:TX
Mailing Address - Zip Code:77619-2905
Mailing Address - Country:US
Mailing Address - Phone:409-962-5733
Mailing Address - Fax:
Practice Address - Street 1:5500 39TH ST
Practice Address - Street 2:
Practice Address - City:GROVES
Practice Address - State:TX
Practice Address - Zip Code:77619-2905
Practice Address - Country:US
Practice Address - Phone:409-962-5733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-05
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100039282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital