| Organization Name: | MEMORIAL MEDICAL CENTER |
| NPI Number: | 1689630865 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JASON ANGLIN (CEO) |
| Mailing Address: | 815 N Virginia St Port Lavaca |
| State: | TX US |
| Postal Code: | 779793025 |
| Phone Number: | 3615526713 |
| Fax Number: | 3615520338 |
| NPI Enumeration Date: | 04/25/2006 |
| NPI Last Update Date: | 08/25/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 282NC0060X |
| License Number: | 000487 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Hospitals |
| Taxonomy Classification: | General Acute Care Hospital |
| Taxonomy Specialization: | Critical Access |
| Taxonomy Definition: | |