Provider Demographics
NPI:1508833906
Name:BAPTIST ST. ANTHONY'S HOSPITAL
Entity Type:Organization
Organization Name:BAPTIST ST. ANTHONY'S HOSPITAL
Other - Org Name:BAPTIST ST. ANTHONY'S HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:PULLIAM
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:806-212-5170
Mailing Address - Street 1:1600 WALLACE BLVD
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-1799
Mailing Address - Country:US
Mailing Address - Phone:802-212-2000
Mailing Address - Fax:
Practice Address - Street 1:600 N TYLER ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79107-5247
Practice Address - Country:US
Practice Address - Phone:806-212-2802
Practice Address - Fax:806-212-7556
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAPTIST ST. ANTHONY'S HEALTH SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-03-03
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX001676251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXHH6909OtherBLUE CROSS
TX45-1509Medicare ID - Type UnspecifiedHOSPICE