Provider Demographics
NPI:1407281330
Name:CHANG GUNG MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:CHANG GUNG MEMORIAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:886
Authorized Official - Prefix:
Authorized Official - First Name:NEUROSURGERY
Authorized Official - Middle Name:
Authorized Official - Last Name:SURGERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:53621-000-2864
Mailing Address - Street 1:6 SECTION WEST, CHIA PU ROAD, PU TZ CITY, CHIA-YI 613
Mailing Address - Street 2:
Mailing Address - City:PU TZ CITY
Mailing Address - State:CHIA-YI
Mailing Address - Zip Code:886
Mailing Address - Country:TW
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6 SECTION WEST, CHIA PU ROAD, PU TZ CITY, CHIA-YI 613,
Practice Address - Street 2:
Practice Address - City:PU TZ CITY
Practice Address - State:CHIA-YI
Practice Address - Zip Code:613
Practice Address - Country:TW
Practice Address - Phone:8865-362-1000
Practice Address - Fax:8865-362-3002
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHANG GUNG MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-09-11
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ040312276400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit