Provider Demographics
NPI:1558474999
Name:COLUMBUS COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:COLUMBUS COMMUNITY HOSPITAL
Other - Org Name:COLUMBUS MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:VANEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-493-7561
Mailing Address - Street 1:2122 HIGHWAY 71 S # 101
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:TX
Mailing Address - Zip Code:78934-3011
Mailing Address - Country:US
Mailing Address - Phone:979-732-2310
Mailing Address - Fax:979-732-2318
Practice Address - Street 1:2122 HWY 71 S
Practice Address - Street 2:# 101
Practice Address - City:COLUMBUS
Practice Address - State:TX
Practice Address - Zip Code:78934-3011
Practice Address - Country:US
Practice Address - Phone:979-732-2318
Practice Address - Fax:979-732-2310
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COLUMBUS COMMUNITY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-17
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QA0005X
261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX112272302Medicaid
TX458608OtherMEDICARE
TX112272305Medicaid