Provider Demographics
NPI:1376529743
Name:MORTON PLANT HOSPITAL ASSOCIATION INC
Entity Type:Organization
Organization Name:MORTON PLANT HOSPITAL ASSOCIATION INC
Other - Org Name:MORTON PLANT HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR, REVENUE MANAGEMENT SVS
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIANT
Authorized Official - Middle Name:
Authorized Official - Last Name:KEEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-519-1672
Mailing Address - Street 1:300 PINELLAS ST
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-3804
Mailing Address - Country:US
Mailing Address - Phone:727-281-9479
Mailing Address - Fax:727-461-8101
Practice Address - Street 1:300 PINELLAS ST
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3804
Practice Address - Country:US
Practice Address - Phone:727-462-7000
Practice Address - Fax:727-461-8101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4064273R00000X, 282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0101583-00Medicaid
FL10D0645549OtherCLIA
FL10D0645549OtherCLIA
FL0101583-00Medicaid
FL100127Medicare Oscar/Certification