Healthcare Provider Details
I. General information
NPI: 1538123617
Provider Name (Legal Business Name): BALLINGER MEMORIAL HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/14/2006
Last Update Date: 01/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2001 HUTCHINS AVENUE SUITE C
BALLINGER TX
76821-4427
US
IV. Provider business mailing address
P.O. BOX 617
BALLINGER TX
76821-0617
US
V. Phone/Fax
- Phone: 325-365-5737
- Fax: 325-365-2405
- Phone: 325-365-2531
- Fax: 325-365-5689
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR1300X |
| Taxonomy | Rural Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RHETT
D.
FRICKE
Title or Position: CEO/ADMINISTRATOR
Credential:
Phone: 325-365-2531