Memorial Hospital

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

000478 Issued in TX

Legal business name

MEMORIAL HOSPITAL

Doing business as

Hospice of Deep East Texas

Practice address

1204 N Mound St
Nacogdoches, TX 75961-4027

Phone

(936) 564-4611

NPI assigned

Jun 29, 2006

Last updated

Jan 28, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jane Ann Bridges, CPA

Title

Chief Financial Officer

Phone

(936) 568-8525

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Hospice of Deep East Texas Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264636800000",
    "number": "1932137916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 N MOUND ST",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759614027",
            "telephone_number": "936-564-4611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 N MOUND ST",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759614027",
            "telephone_number": "936-564-4611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-29",
        "last_updated": "2010-01-28",
        "status": "A",
        "authorized_official_last_name": "BRIDGES",
        "authorized_official_first_name": "JANE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "936-568-8525",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "TX",
            "license": "000478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000205000",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hospice of Deep East Texas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephanie Medina, ATC
• Medquinox
• Maegan Melton
• Memorial Hospital
• Memorial Hospital
• Maura Colleen Messer
• Christina Baumgart Meyers, LPC
• Sylvia Middlebrook, PH.D.
• Donald R. Migl, O.D.
• Sanford Eugene Miller, ATC/LAT

• Community Based Hospice Care Agency in Nacogdoches, TX
• Providers in Nacogdoches, TX by specialty
• Community Based Hospice Care Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.