Provider Demographics
NPI:1558607598
Name:MEMORIAL HERMANN HOSPITAL SYSTEM
Entity Type:Organization
Organization Name:MEMORIAL HERMANN HOSPITAL SYSTEM
Other - Org Name:MEMORIAL HERMANN HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:LARAWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-242-2707
Mailing Address - Street 1:PO BOX 201016
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77216-0001
Mailing Address - Country:US
Mailing Address - Phone:713-338-4127
Mailing Address - Fax:713-338-4158
Practice Address - Street 1:920 FROSTWOOD DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2314
Practice Address - Country:US
Practice Address - Phone:713-338-7300
Practice Address - Fax:713-338-7303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-19
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007860251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health