Provider Demographics
NPI:1881670339
Name:SCCI HOSPITALS OF AMERICA INC
Entity Type:Organization
Organization Name:SCCI HOSPITALS OF AMERICA INC
Other - Org Name:TRIUMPH HOSPITAL SAN ANGELO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP, QUALITY AND COMPLIANCE
Authorized Official - Prefix:MS
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:LANFORD
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MBA
Authorized Official - Phone:713-807-8686
Mailing Address - Street 1:7333 NORTH FWY
Mailing Address - Street 2:SUITE 500
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77076-1300
Mailing Address - Country:US
Mailing Address - Phone:713-807-8686
Mailing Address - Fax:713-807-8604
Practice Address - Street 1:120 E HARRIS AVE
Practice Address - Street 2:6TH FLOOR
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76903-5904
Practice Address - Country:US
Practice Address - Phone:325-659-3906
Practice Address - Fax:325-659-3838
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEW TRIUMPH HEALTHCARE OF TEXAS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-12-16
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000819282E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX144752601Medicaid
TXHH0963OtherBLUE CROSS
452064Medicare ID - Type Unspecified