Healthcare Provider Details

I. General information

NPI: 1063418937
Provider Name (Legal Business Name): HENDRICK MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2005
Last Update Date: 10/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 PINE ST
ABILENE TX
79601-2432
US

IV. Provider business mailing address

1900 PINE ST
ABILENE TX
79601-2432
US

V. Phone/Fax

Practice location:
  • Phone: 325-670-2000
  • Fax:
Mailing address:
  • Phone: 325-670-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number000500
License Number StateTX

VIII. Authorized Official

Name: STEPHEN KIMMEL
Title or Position: CEO
Credential:
Phone: 325-670-2000