Provider Demographics
NPI:1457358103
Name:BELLVILLE HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:BELLVILLE HOSPITAL DISTRICT
Other - Org Name:BELLVILLE GENERAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:979-865-3141
Mailing Address - Street 1:44 N CUMMINGS
Mailing Address - Street 2:
Mailing Address - City:BELLVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77418-0977
Mailing Address - Country:US
Mailing Address - Phone:979-865-3141
Mailing Address - Fax:979-865-9631
Practice Address - Street 1:44 N CUMMINGS
Practice Address - Street 2:
Practice Address - City:BELLVILLE
Practice Address - State:TX
Practice Address - Zip Code:77418-0977
Practice Address - Country:US
Practice Address - Phone:979-865-3141
Practice Address - Fax:979-865-9631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000552207P00000X, 282N00000X
TX552261QA1903X, 275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282N00000XHospitalsGeneral Acute Care Hospital
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX083290904Medicaid
TXHH0212OtherBLUECROSS BLUESHIELD
TXHH2448OtherBCBS SWINGBED
TX0832909-06Medicaid
TX00J98XOtherBLUECROSS BLUESHIELD - ER
TX0832909-05Medicaid
TX00J98XOtherBLUECROSS BLUESHIELD - ER
TXHH0212OtherBLUECROSS BLUESHIELD
TX00376TMedicare PIN