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NPI Code Detail

MEDICARE: EASTLAND MEMORIAL HOSPITAL DISTRICT

MEDICARE: EASTLAND MEMORIAL HOSPITAL DISTRICT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility1014955TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
167-6141OTHERTXMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043623200
Entity Type Code : Organization
Provider Name (Legal Business Name) : EASTLAND MEMORIAL HOSPITAL DISTRICT
Provider Business Mailing Address
First Line : 304 S DAUGHERTY AVE
Second Line : P.O. BOX 897
City : EASTLAND
State : TX
Zip : 76448-2609
Country : US
Telephone Number : 254-631-5342
Fax Number : 254-629-8929
Provider Business Practice Location Address
First Line : 7100 MATLOCK RD
Second Line :
City : ARLINGTON
State : TX
Zip : 76002-3402
Country : US
Telephone Number : 817-466-2511
Fax Number :
Authorized Official
Title or Position : ADMINISTRATOR
Name : MR. TED D. MATTHEWS
Credential :
Telephone Number : 254-631-5342
Provider Enumeration Date : 06/05/2014
Last Update Date : 06/05/2014

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Directions to “EASTLAND MEMORIAL HOSPITAL DISTRICT ” Practice Location

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