Provider Demographics
NPI:1790703379
Name:PINEY WOODS HEALTHCARE SYSTEM LP
Entity Type:Organization
Organization Name:PINEY WOODS HEALTHCARE SYSTEM LP
Other - Org Name:WOODLAND HEIGHTS MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR, BUSINESS OFFICE SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLTSFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-465-7466
Mailing Address - Street 1:209 GASLIGHT BLVD
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75904-3134
Mailing Address - Country:US
Mailing Address - Phone:936-634-8311
Mailing Address - Fax:936-637-8600
Practice Address - Street 1:505 S JOHN REDDITT DR
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-3120
Practice Address - Country:US
Practice Address - Phone:936-634-8311
Practice Address - Fax:936-637-8600
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PINEY WOODS HEALTHCARE SYSTEM LP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-18
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000481273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
45T484Medicare Oscar/Certification