Healthcare Provider Details
I. General information
NPI: 1659300911
Provider Name (Legal Business Name): PREFERRED HOSPITAL LEASING ELDORADO, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/30/2006
Last Update Date: 08/01/2025
Certification Date: 08/01/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
102 N. NORTH US HIGHWAY 277
ELDORADO TX
76936-1246
US
IV. Provider business mailing address
102 N US HIGHWAY 277 P.O. BOX V
ELDORADO TX
76936-4010
US
V. Phone/Fax
- Phone: 325-853-2507
- Fax:
- Phone: 325-853-2507
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | 008340 |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 275N00000X |
| Taxonomy | Medicare Defined Swing Bed Hospital Unit |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DONALD
A
FREEMAN
Title or Position: PRESIDENT
Credential:
Phone: 405-878-0202