MEDICARE: CHAMBERS COUNTY PUBLIC HOSPITAL DISTRICT NO 1

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QF0400X	Federally Qualified Health Center (FQHC)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831338490
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHAMBERS COUNTY PUBLIC HOSPITAL DISTRICT NO 1

Provider Business Mailing Address
First Line	:	PO BOX 398
Second Line	:
City	:	ANAHUAC
State	:	TX
Zip	:	77514-0398
Country	:	US
Telephone Number	:	281-576-0670
Fax Number	:	281-576-0673

Provider Business Practice Location Address
First Line	:	9825 EAGLE DR
Second Line	:
City	:	BAYTOWN
State	:	TX
Zip	:	77523-9847
Country	:	US
Telephone Number	:	281-576-0670
Fax Number	:	281-576-0673

Authorized Official
Title or Position	:	CEO
Name	:	ROBERT PASCASIO
Credential	:
Telephone Number	:	409-267-3143

Provider Enumeration Date	:	02/05/2009
Last Update Date	:	05/08/2023

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