Provider Demographics
NPI:1720364037
Name:EL CAMPO MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:EL CAMPO MEMORIAL HOSPITAL
Other - Org Name:EL CAMPO MEMORIAL HOSPITAL SWING BED
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TUDOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-578-5250
Mailing Address - Street 1:303 SANDY CORNER RD
Mailing Address - Street 2:
Mailing Address - City:EL CAMPO
Mailing Address - State:TX
Mailing Address - Zip Code:77437-9535
Mailing Address - Country:US
Mailing Address - Phone:979-543-6251
Mailing Address - Fax:979-543-8420
Practice Address - Street 1:303 SANDY CORNER RD
Practice Address - Street 2:
Practice Address - City:EL CAMPO
Practice Address - State:TX
Practice Address - Zip Code:77437-9535
Practice Address - Country:US
Practice Address - Phone:979-543-6251
Practice Address - Fax:979-543-8420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-01
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000426275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX45U694Medicare Oscar/Certification