# MEMORIAL HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MEMORIAL HOSPITAL
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235158205
- **Authorized official:** DAVID SCHAEFER (PHARMACY DIRECTOR)
- **Authorized official phone:** (936) 568-8415

## Contact information

- **Practice address:** 1204 N MOUND ST, NACOGDOCHES, TX 75961-4027
- **Practice address phone:** (936) 569-4657
- **Practice address fax:** (936) 569-4689
- **Mailing address:** 1204 N MOUND ST, NACOGDOCHES, TX 75961-4027
- **Mailing address phone:** (936) 569-4657
- **Mailing address fax:** (936) 569-4689

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336I0012X | Institutional Pharmacy | 3104 | TX | Yes |

## Other

- **Enumeration date:** 07/19/2006
- **Last updated:** 01/14/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2097683 | PK | — |
| 05 | — | 250249 | — | TX |