Healthcare Provider Details

I. General information

NPI: 1891762860
Provider Name (Legal Business Name): BAPTIST ST. ANTHONY'S HOSPITAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2006
Last Update Date: 12/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 WALLACE BLVD
AMARILLO TX
79106-1799
US

IV. Provider business mailing address

1600 WALLACE BLVD
AMARILLO TX
79106-1799
US

V. Phone/Fax

Practice location:
  • Phone: 806-212-2000
  • Fax:
Mailing address:
  • Phone: 806-212-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number000001
License Number StateTX

VIII. Authorized Official

Name: MRS. ELIZABETH A PULLIAM
Title or Position: CFO
Credential: CPA
Phone: 806-212-5170