Organization
COLUMBUS COMMUNITY HOSPITAL
Active
Other names
FOUR OAKS MEDICAL CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES E. VANEK (CHIEF EXECUTIVE OFFICER)
(979) 493-7650
Entity
Organization
Contact information
Practice address
109 SHULT DR, COLUMBUS, TX 78934-3015
(979) 732-5794
(979) 732-5795
Mailing address
109 SHULT DR, COLUMBUS, TX 78934-3009
(979) 732-5794
(979) 732-5795
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1268898-02
EPSDT
TX
05
—
1268898-04
—
TX
01
—
453415
MEDICARE
TX
Enumeration date
05/10/2006
Last updated
07/19/2022
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