COLUMBIA HOSPITAL AT MEDICAL CITY DALLAS SUBSIDIARY LP

Provider Demographics

• NPI: 1689628984
• Name: COLUMBIA HOSPITAL AT MEDICAL CITY DALLAS SUBSIDIARY LP
• Entity Type: Organization
• Organization Name: COLUMBIA HOSPITAL AT MEDICAL CITY DALLAS SUBSIDIARY LP
• Other - Org Name: MEDICAL CITY DALLAS
• Other - Org Type: Doing Business As
• Authorized Official - Title/Position: CFO
• Authorized Official - First Name: SCOTT
• Authorized Official - Last Name: ANDERTON
• Authorized Official - Phone: 972-566-6225
• Mailing Address - Street 1: 7777 FOREST LN
• Mailing Address - City: DALLAS
• Mailing Address - State: TX
• Mailing Address - Zip Code: 75230-2505
• Mailing Address - Country: US
• Mailing Address - Phone: 972-566-7000
• Mailing Address - Fax: 972-566-6248
• Practice Address - Street 1: 7777 FOREST LN
• Practice Address - City: DALLAS
• Practice Address - State: TX
• Practice Address - Zip Code: 75230-2505
• Practice Address - Country: US
• Practice Address - Phone: 972-566-7000
• Practice Address - Fax: 972-566-6248
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2006-05-20
• Last Update Date: 2023-08-10

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	282N00000X	Hospitals	General Acute Care Hospital

Provider Identifiers

State	Identifier ID	ID Type	Issuer
MS	01401615	Medicaid
VT	0450647	Medicaid
WA	3018488	Medicaid
AZ	407355	Medicaid
CO	95015236	Medicaid
KY	01600873	Medicaid
NE	10024974100	Medicaid
NC	4500647	Medicaid
TX	HH0706	Other	BLUE CROSS
TX	020943901	Medicaid
IA	0570044	Medicaid
OK	100697860A	Medicaid
NM	A5981	Medicaid
AL	HOS0647N	Medicaid
CA	XHSP33559	Medicaid
SD	0131580	Medicaid
KS	100299410A	Medicaid
GA	000953862X	Medicaid
ND	01614	Medicaid
NY	01818831	Medicaid
	166006500	Other	DEPT OF LABOR
LA	1700622	Medicaid
MO	016838005	Medicaid
MN	023366800	Medicaid
AR	116539105	Medicaid
OH	2458942	Medicaid
NJ	6170307	Medicaid
IN	100380160A	Medicaid
WY	119325200	Medicaid
FL	907716200	Medicaid
KY	01600873	Medicaid
TX	020943901	Medicaid
NM	A5981	Medicaid