Pittsburg Hospital LLC

Organization Active NPI Internal Medicine Physician · Pittsburg, TX

NPI 1942700331 · NPPES record last updated Jul 29, 2019

Key facts

NPI
1942700331
Entity type
Organization (NPI type 2)
Primary specialty
Internal Medicine Physician 207R00000X
Legal business name
PITTSBURG HOSPITAL LLC
Practice address
2701 US Highway 271 N
Pittsburg, TX 75686-4289
Phone
(903) 946-5442
Fax
(903) 946-5258
NPI assigned
Feb 13, 2018
Organization subpart
Yes
Parent organization (as reported)
AHS EAST TEXAS HEALTH SYSTEM, LLC

Authorized official

Name
Stephen C. Petrovich
Title
Evp
Phone
(615) 296-3000

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 5

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 32

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 32

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20180604001525 TX Part B Supplier - Clinic/Group Practice 5597029272 Receives reassigned benefits from 19 practitioners
3 other NPIs on this enrollment
Practice locations: Mt Pleasant, TX; Pittsburg, TX

National Provider Directory

Tax ID family
Pittsburg Hospital LLC (6 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207R00000X Yes
Certified Registered Nurse Anesthetist
Group: 193200000X MULTI-SPECIALTY GROUP
367500000X

Addresses

Primary practice location

2701 US Highway 271 N
Pittsburg, TX 75686-4289

Mailing address

1 Burton Hills Blvd Ste 250
Nashville, TN 37215-6195
Phone (615) 296-3000

Other providers in Pittsburg, TX

All providers in Pittsburg, TX · Internal Medicine Physician in Texas

Sources for this page

Verify at the official NPI Registry.