Healthcare Provider Details

I. General information

NPI: 1407809684
Provider Name (Legal Business Name): FRIO HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 02/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

507 E GREEN ST
LLANO TX
78643-2717
US

IV. Provider business mailing address

200 S IH 35
PEARSALL TX
78061-6601
US

V. Phone/Fax

Practice location:
  • Phone: 325-247-4115
  • Fax: 325-247-3978
Mailing address:
  • Phone: 830-334-3617
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number116403
License Number StateTX

VIII. Authorized Official

Name: THOMAS GRIMERT
Title or Position: CEO
Credential:
Phone: 830-334-3617