MEDICARE: SABINE COUNTY 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
1	207P00000X	Emergency Medicine Physician
2	2085R0202X	Diagnostic Radiology Physician
3	282N00000X	General Acute Care Hospital	000522	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00D925	OTHER	TX	BLUECROSSBLUE SHILELD DR
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	45D0659755	OTHER	TX	CLIA
4	HH0748	OTHER	TX	BLUE CROSS BLUE SHIELD HO
5	0933870	OTHER	TX	CIGNA
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508862921
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SABINE COUNTY HOSPITAL DISTRICT

Provider Business Mailing Address
First Line	:	P O BOX 750
Second Line	:
City	:	HEMPHILL
State	:	TX
Zip	:	75948
Country	:	US
Telephone Number	:	409-787-3300
Fax Number	:	409-787-1010

Provider Business Practice Location Address
First Line	:	2301 HWY 83 WEST
Second Line	:
City	:	HEMPHILL
State	:	TX
Zip	:	75948
Country	:	US
Telephone Number	:	409-787-3300
Fax Number	:	409-787-1010

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. DEANNA LATHROP
Credential	:
Telephone Number	:	409-787-3300

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	07/08/2008

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Directions to “SABINE COUNTY HOSPITAL DISTRICT ” Practice Location

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