Healthcare Provider Details

I. General information

NPI: 1942700331
Provider Name (Legal Business Name): PITTSBURG HOSPITAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2018
Last Update Date: 07/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2701 US HIGHWAY 271 N
PITTSBURG TX
75686-4289
US

IV. Provider business mailing address

1 BURTON HILLS BLVD STE 250
NASHVILLE TN
37215-6195
US

V. Phone/Fax

Practice location:
  • Phone: 903-946-5442
  • Fax: 903-946-5258
Mailing address:
  • Phone: 615-296-3000
  • Fax: 615-296-6227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN C. PETROVICH
Title or Position: EVP
Credential:
Phone: 615-296-3000