Healthcare Provider Details
I. General information
NPI: 1225038938
Provider Name (Legal Business Name): BALLINGER MEMORIAL HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/22/2005
Last Update Date: 08/05/2024
Certification Date: 08/05/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
608 AVENUE B
BALLINGER TX
76821-2406
US
IV. Provider business mailing address
PO BOX 617
BALLINGER TX
76821-0617
US
V. Phone/Fax
- Phone: 325-365-2531
- Fax: 325-365-5689
- Phone: 325-365-2531
- Fax: 325-365-5689
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 282NC0060X |
| Taxonomy | Critical Access Hospital |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | |
| License Number State | TX |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 282NC0060X |
| Taxonomy | Critical Access Hospital |
| License Number | 000234 |
| License Number State | TX |
VIII. Authorized Official
Name: MR.
RHETT
D.
FRICKE
Title or Position: CEO/ADMINISTRATOR
Credential:
Phone: 325-365-2531