Provider Demographics
NPI:1649587437
Name:EDWARD WHITE HOSPITAL, INC.
Entity Type:Organization
Organization Name:EDWARD WHITE HOSPITAL, INC.
Other - Org Name:EDWARD WHITE HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DREW
Authorized Official - Middle Name:
Authorized Official - Last Name:STRAUCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-328-6157
Mailing Address - Street 1:2323 9TH AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-6832
Mailing Address - Country:US
Mailing Address - Phone:727-323-1111
Mailing Address - Fax:727-528-6135
Practice Address - Street 1:2323 9TH AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-6832
Practice Address - Country:US
Practice Address - Phone:727-323-1111
Practice Address - Fax:727-528-6135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-01
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
106087Medicare Oscar/Certification