Provider Demographics
NPI:1629271630
Name:BIG BEND HOSPITAL CORPORATION
Entity Type:Organization
Organization Name:BIG BEND HOSPITAL CORPORATION
Other - Org Name:BIG BEND REGIONAL MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BREWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-465-7626
Mailing Address - Street 1:7100 COMMERCE WAY
Mailing Address - Street 2:SUITE 180
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-2829
Mailing Address - Country:US
Mailing Address - Phone:615-465-7626
Mailing Address - Fax:615-465-3007
Practice Address - Street 1:2600 N HWY 118
Practice Address - Street 2:
Practice Address - City:ALPINE
Practice Address - State:TX
Practice Address - Zip Code:79830-2002
Practice Address - Country:US
Practice Address - Phone:432-837-0242
Practice Address - Fax:432-837-0330
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BIG BEND HOSPITAL CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-06-07
Last Update Date:2010-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0A6090Medicare PIN