Healthcare Provider Details

I. General information

NPI: 1316203573
Provider Name (Legal Business Name): BALLINGER MEMORIAL HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2012
Last Update Date: 10/26/2020
Certification Date: 10/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 HUTCHINS AVE SUITE A
BALLINGER TX
76821-4452
US

IV. Provider business mailing address

PO BOX 617
BALLINGER TX
76821-0617
US

V. Phone/Fax

Practice location:
  • Phone: 325-365-3505
  • Fax: 325-365-5376
Mailing address:
  • Phone: 325-365-3505
  • Fax: 325-365-5376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number28000
License Number StateTX

VIII. Authorized Official

Name: RHETT FRICKE
Title or Position: CEO/ADMINISTRATOR
Credential:
Phone: 325-365-2531