Healthcare Provider Details

I. General information

NPI: 1215991039
Provider Name (Legal Business Name): BALLINGER MEMORIAL HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2006
Last Update Date: 01/25/2016
Certification Date:
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

Practice location:
  • Phone: 325-365-2531
  • Fax: 325-365-2662
Mailing address:
  • Phone: 325-365-2531
  • Fax: 325-365-2662

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number300102
License Number StateTX

VIII. Authorized Official

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