COLUMBIA MEDICAL CENTER OF ARLINGTON SUBSIDIARY LP

Provider Demographics

• NPI: 1134172406
• Name: COLUMBIA MEDICAL CENTER OF ARLINGTON SUBSIDIARY LP
• Entity type: Organization
• Organization Name: COLUMBIA MEDICAL CENTER OF ARLINGTON SUBSIDIARY LP
• Other - Org Name: <UNAVAIL>
• Authorized Official - Title/Position: CFO
• Authorized Official - First Name: JEFF
• Authorized Official - Last Name: ARDEMAGNI
• Authorized Official - Phone: 817-472-4909
• Mailing Address - Street 1: 3301 MATLOCK RD
• Mailing Address - City: ARLINGTON
• Mailing Address - State: TX
• Mailing Address - Zip Code: 76015-2908
• Mailing Address - Country: US
• Mailing Address - Phone: 817-465-3241
• Mailing Address - Fax: 817-472-4878
• Practice Address - Street 1: 3301 MATLOCK RD
• Practice Address - City: ARLINGTON
• Practice Address - State: TX
• Practice Address - Zip Code: 76015-2908
• Practice Address - Country: US
• Practice Address - Phone: 817-465-3241
• Practice Address - Fax: 817-472-4878
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2006-05-18
• Last Update Date: 2021-06-03

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	282N00000X	Hospitals	General Acute Care Hospital

Provider Identifiers

State	Identifier ID	ID Type	Issuer
IA	0555599	Medicaid
OR	100364	Medicaid
CA	XHSP33592	Medicaid
GA	000953873X	Medicaid
FL	010333100	Medicaid
SD	0124030	Medicaid
NV	100504252	Medicaid
KS	200260770A	Medicaid
MD	401533900	Medicaid
MA	1001337	Medicaid
LA	1702340	Medicaid
CO	37308777	Medicaid
NC	4500675	Medicaid
AL	HOS0675N	Medicaid
MO	015873904	Medicaid
	203282400	Other	DEPT OF LABOR
VA	4506758	Medicaid
NJ	9073906	Medicaid
MS	04458031	Medicaid
PA	100858965000	Medicaid
MN	104778700	Medicaid
OK	200041950A	Medicaid
WA	3025210	Medicaid
TN	0450675	Medicaid
IN	200373600A	Medicaid
AZ	629925	Medicaid
ID	807271800	Medicaid
TX	020950401	Medicaid
AR	149056105	Medicaid
NM	21501505	Medicaid
OH	2483889	Medicaid
	HH0579	Other	BLUE CROSS
CO	37308777	Medicaid
IL	=========001	Medicaid
AL	HOS0675N	Medicaid
	450675	Medicare Oscar/Certification