Healthcare Provider Details

I. General information

NPI: 1699166389
Provider Name (Legal Business Name): SETON FAMILY OF HOSPITALS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2015
Last Update Date: 01/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4900 MUELLER BLVD PHARMACY DEPT
AUSTIN TX
78723-3079
US

IV. Provider business mailing address

1345 PHILOMENA ST 362
AUSTIN TX
78723-1930
US

V. Phone/Fax

Practice location:
  • Phone: 512-324-0149
  • Fax: 512-324-8225
Mailing address:
  • Phone: 512-324-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number16884
License Number StateTX

VIII. Authorized Official

Name: JULIE HOLLY
Title or Position: REGIONAL DIRECTOR NET REV & REIMB
Credential:
Phone: 512-324-3269