Provider Demographics
NPI:1821178336
Name:REFUGIO COUNTY MEMORIAL HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:REFUGIO COUNTY MEMORIAL HOSPITAL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:COREY
Authorized Official - Middle Name:
Authorized Official - Last Name:WASICEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-526-2321
Mailing Address - Street 1:107 SWIFT ST
Mailing Address - Street 2:
Mailing Address - City:REFUGIO
Mailing Address - State:TX
Mailing Address - Zip Code:78377-2425
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:107 SWIFT ST
Practice Address - Street 2:
Practice Address - City:REFUGIO
Practice Address - State:TX
Practice Address - Zip Code:78377-2425
Practice Address - Country:US
Practice Address - Phone:361-526-2321
Practice Address - Fax:361-526-2420
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REFUGIO COUNTY MEMORIAL HOSPITAL DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-17
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX084616401Medicaid
TX00QW27Medicare ID - Type UnspecifiedMCR/BCBS PROFEE