Healthcare Provider Details

I. General information

NPI: 1427539691
Provider Name (Legal Business Name): SOUTH LIMESTONE HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2018
Last Update Date: 07/21/2020
Certification Date: 07/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 W TRINITY ST
GROESBECK TX
76642-1324
US

IV. Provider business mailing address

701 MCCLINTIC DR
GROESBECK TX
76642-2128
US

V. Phone/Fax

Practice location:
  • Phone: 254-729-3740
  • Fax: 254-729-2315
Mailing address:
  • Phone: 254-729-3281
  • Fax: 254-729-3080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

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