Provider Demographics
NPI:1336911593
Name:GERIATRIC HOSPITAL MEDICINE
Entity type:Organization
Organization Name:GERIATRIC HOSPITAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MEGUMI
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGUCHI ALDRETE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-870-2752
Mailing Address - Street 1:9013 UNIVERSITY PKWY STE G
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-9421
Mailing Address - Country:US
Mailing Address - Phone:504-781-3128
Mailing Address - Fax:850-912-8150
Practice Address - Street 1:5151 N 9TH AVE
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-8721
Practice Address - Country:US
Practice Address - Phone:713-870-2752
Practice Address - Fax:850-912-8150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-23
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty