Provider Demographics
NPI:1144251216
Name:PALM BEACH GARDENS COMMUNITY HOSPITAL, INC.
Entity type:Organization
Organization Name:PALM BEACH GARDENS COMMUNITY HOSPITAL, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:461-488-8140
Mailing Address - Street 1:PO BOX 741241
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-1241
Mailing Address - Country:US
Mailing Address - Phone:561-982-2189
Mailing Address - Fax:561-694-7160
Practice Address - Street 1:3360 BURNS RD
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-4323
Practice Address - Country:US
Practice Address - Phone:561-622-1411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4127282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL010210500Medicaid
100176B000000OtherSECTION 1011
104064OtherAVMED
33639OtherCOVENTRY HEALTH CARE GROU
080094OtherHUMANA
852955840OtherAETNA US HEALTHCARE (NATI
990230OtherNEIGHBORHOOD HEALTH PLAN
PBG1000OtherNEIGHBORHOOD HEALTH PLAN
262OtherBCBS OF FLORIDA
86174OtherCOVENTRY HEALTH CARE IOWA
33639OtherCOVENTRY HEALTH CARE GROU