Healthcare Provider Details

I. General information

NPI: 1689112377
Provider Name (Legal Business Name): SOUTH LIMESTONE HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2017
Last Update Date: 02/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2104 N KARNES AVE
CAMERON TX
76520-1055
US

IV. Provider business mailing address

701 MCCLINTIC DR
GROESBECK TX
76642-2128
US

V. Phone/Fax

Practice location:
  • Phone: 254-697-4985
  • Fax: 254-697-2129
Mailing address:
  • Phone: 254-729-3281
  • Fax: 254-729-2689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number5289
License Number StateTX

VIII. Authorized Official

Name: MR. LARRY N PRICE
Title or Position: CEO
Credential:
Phone: 254-729-3281