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General NPI Number Information
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NPI Number | 1457376733
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Entity Type | Organization
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Legal Business Name | COLORADO FAYETTE MEDICAL CENTER
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 03/27/2012
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Provider Practice Location Address
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Address Line | 400 YOUENS DR
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City | WEIMAR
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State | TX
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Zip | 78962-3680
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Country | US
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Telephone | 979-725-9531
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Fax | 979-725-8132
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Provider Business Mailing Address
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Address Line | 400 YOUENS DR
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City | WEIMAR
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State | TX
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Zip | 78962-3680
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Country | US
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Telephone | 979-725-9531
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Fax | 979-725-8132
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Authorized Official
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Title or Position | CEO
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Name | STEVEN E GULARTE
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Credential |
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Telephone | 979-725-9531
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NR1301X
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Taxonomy Name | Rural Acute Care Hospital
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License Number | 000005
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License Number State | TX
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