Healthcare Provider Details

I. General information

NPI: 1396959037
Provider Name (Legal Business Name): BAPTIST MEMORIALS MINISTRIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 02/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

902 NORTH MAIN STREET
SAN ANGELO TX
76903
US

IV. Provider business mailing address

902 NORTH MAIN STREET P O BOX 5661
SAN ANGELO TX
76903
US

V. Phone/Fax

Practice location:
  • Phone: 325-655-7391
  • Fax: 325-653-1413
Mailing address:
  • Phone: 325-655-7391
  • Fax: 325-653-1413

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number006924
License Number StateTX

VIII. Authorized Official

Name: MR. AARON HARGETT
Title or Position: ADMINISTRATOR
Credential:
Phone: 325-657-9102