MEDICARE: LAREDO REGIONAL MEDICAL CENTER L P

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	301	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	233001904	OTHER	TX	CHAMPUS

General Provider Information

NPI Number	:	1588650295
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAREDO REGIONAL MEDICAL CENTER L P

Provider Business Mailing Address
First Line	:	10700 MCPHERSON RD
Second Line	:
City	:	LAREDO
State	:	TX
Zip	:	78045-6268
Country	:	US
Telephone Number	:	956-523-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	10700 MCPHERSON RD
Second Line	:
City	:	LAREDO
State	:	TX
Zip	:	78045-6268
Country	:	US
Telephone Number	:	956-523-2000
Fax Number	:

Authorized Official
Title or Position	:	CFO, SENIOR VP
Name	:	STEVE FILTON
Credential	:
Telephone Number	:	610-768-3300

Provider Enumeration Date	:	09/27/2005
Last Update Date	:	07/01/2010

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