Healthcare Provider Details

I. General information

NPI: 1740238641
Provider Name (Legal Business Name): COLUMBUS COMMUNITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 06/28/2021
Certification Date: 06/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 SHULT DR
COLUMBUS TX
78934-3016
US

IV. Provider business mailing address

110 SHULT DR
COLUMBUS TX
78934-3016
US

V. Phone/Fax

Practice location:
  • Phone: 979-732-2371
  • Fax: 979-732-9242
Mailing address:
  • Phone: 979-732-2371
  • Fax: 979-732-9242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NR1301X
TaxonomyRural Acute Care Hospital
License Number000014
License Number StateTX

VIII. Authorized Official

Name: MR. JAMES E. VANEK
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 979-732-7561