Healthcare Provider Details

I. General information

NPI: 1902840333
Provider Name (Legal Business Name): SHERMAN GRAYSON HOSPITAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 06/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 S FM 1417
SHERMAN TX
75092-4865
US

IV. Provider business mailing address

119 W HOUSTON ST
SHERMAN TX
75090-5909
US

V. Phone/Fax

Practice location:
  • Phone: 903-870-4611
  • Fax: 903-891-2030
Mailing address:
  • Phone: 903-891-7000
  • Fax: 903-813-1479

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. VANCE VERNON REYNOLDS
Title or Position: PRESIDENT & CHIEF EXECUTIVE OFFICER
Credential:
Phone: 903-870-4591