Provider Demographics
NPI:1366858938
Name:BAXTER HEALTHCARE CORPORATION
Entity Type:Organization
Organization Name:BAXTER HEALTHCARE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR MEDICAL SCIENCE LIAISON
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:ZASTAWNY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:830-226-5015
Mailing Address - Street 1:1618 SHADY HOLW
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78132-2354
Mailing Address - Country:US
Mailing Address - Phone:830-226-5015
Mailing Address - Fax:
Practice Address - Street 1:1618 SHADY HOLW
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78132-2354
Practice Address - Country:US
Practice Address - Phone:830-226-5015
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-03
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX286500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX293178OtherBCPS CERTIFICATION NUMBER
OH03-1-14718OtherSTATE PHARMACIST LICENSE
TX30673OtherSTATE PHARMACIST LICENSE