Provider Demographics
NPI:1205286812
Name:WEIMAR MEDICAL HOLDINGS LLC
Entity type:Organization
Organization Name:WEIMAR MEDICAL HOLDINGS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:IRVING
Authorized Official - Middle Name:
Authorized Official - Last Name:SAWYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-725-8274
Mailing Address - Street 1:400 YOUENS DR
Mailing Address - Street 2:
Mailing Address - City:WEIMAR
Mailing Address - State:TX
Mailing Address - Zip Code:78962-3680
Mailing Address - Country:US
Mailing Address - Phone:979-725-8274
Mailing Address - Fax:979-725-8268
Practice Address - Street 1:400 YOUENS DRIVE
Practice Address - Street 2:
Practice Address - City:WEIMAR
Practice Address - State:TEXAS
Practice Address - Zip Code:77474
Practice Address - Country:UM
Practice Address - Phone:979-725-8274
Practice Address - Fax:979-725-8268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-14
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100286275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX670114Medicare UPIN