Organization
EAST TEXAS MEDICAL CENTER PITTSBURG
Active
Other names
ETMC Pittsburg
Organization subpart
No
Provider details
NPI number
Authorized official
MR. W PERRY HENDERSON (ADMINISTRATOR)
(903) 856-4501
Entity
Organization
Contact information
Practice address
2701 U.S. HWY 271 N, PITTSBURG, TX 75686-4289
(903) 946-5000
(903) 946-5598
Mailing address
P.O. BOX 1304, PITTSBURG, TX 75686-2203
(903) 946-5519
(903) 946-5531
Taxonomy
Speciality
Code
Description
License number
State
275N00000X
Medicare Defined Swing Bed Hospital Unit
NA
TX
282NC0060X
Critical Access Hospital
Primary
000438
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00J75T
BCBS
—
05
—
138374701
—
TX
05
—
138374706
—
TX
01
—
C635
BCBS
—
01
—
CF8842
PALMETTO GBA
—
01
—
HH0096
BCBS
—
Enumeration date
05/09/2006
Last updated
10/15/2009
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