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General NPI Number Information
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NPI Number | 1790703379
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Entity Type | Organization
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Legal Business Name | PINEY WOODS HEALTHCARE SYSTEM LP
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 11/06/2007
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Provider Practice Location Address
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Address Line | 505 S JOHN REDDITT DR
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City | LUFKIN
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State | TX
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Zip | 75904-3120
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Country | US
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Telephone | 936-634-8311
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Fax | 936-637-8600
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Provider Business Mailing Address
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Address Line | 209 GASLIGHT BLVD
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City | LUFKIN
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State | TX
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Zip | 75904-3134
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Country | US
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Telephone | 936-634-8311
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Fax | 936-637-8600
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Authorized Official
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Title or Position | DIRECTOR, BUSINESS OFFICE SERVICES
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Name | LAURIE HOLTSFORD
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Credential |
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Telephone | 615-465-7466
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273Y00000X
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Taxonomy Name | Rehabilitation Hospital Unit
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License Number | 000481
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License Number State | TX
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