Provider Demographics
NPI:1962633784
Name:BELLVILLE GENERAL HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:BELLVILLE GENERAL HOSPITAL DISTRICT
Other - Org Name:BELLVILLE GENERAL HOSPITAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:PICKETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-865-3141
Mailing Address - Street 1:44 N CUMMINGS ST
Mailing Address - Street 2:
Mailing Address - City:BELLVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77418-1347
Mailing Address - Country:US
Mailing Address - Phone:979-865-3141
Mailing Address - Fax:979-865-9631
Practice Address - Street 1:44 N CUMMINGS ST
Practice Address - Street 2:
Practice Address - City:BELLVILLE
Practice Address - State:TX
Practice Address - Zip Code:77418-1347
Practice Address - Country:US
Practice Address - Phone:979-865-3141
Practice Address - Fax:979-865-9631
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BELLVILLE GENERAL HOSPITAL DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-07-28
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000552261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health