Provider Demographics
NPI:1942773874
Name:EL CAMPO MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:EL CAMPO MEMORIAL HOSPITAL
Other - Org Name:MID COAST MEDICAL CLINIC-PALACIOS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:M
Authorized Official - Last Name:CRISP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-543-5510
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:979-543-5510
Mailing Address - Fax:
Practice Address - Street 1:307 GREEN AVE
Practice Address - Street 2:
Practice Address - City:PALACIOS
Practice Address - State:TX
Practice Address - Zip Code:77465-3213
Practice Address - Country:US
Practice Address - Phone:361-972-2000
Practice Address - Fax:361-972-2009
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EL CAMPO MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center