Provider Demographics
NPI:1659543429
Name:FOREST PARK MEDICAL CENTER LLC
Entity Type:Organization
Organization Name:FOREST PARK MEDICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:BLEDSOE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:469-624-5796
Mailing Address - Street 1:11990 N CENTRAL EXPY
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-3714
Mailing Address - Country:US
Mailing Address - Phone:469-624-5752
Mailing Address - Fax:
Practice Address - Street 1:11990 N CENTRAL EXPY
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-3714
Practice Address - Country:US
Practice Address - Phone:469-624-5752
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-01
Last Update Date:2013-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital