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General NPI Number Information
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NPI Number | 1063409977
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Entity Type | Organization
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Legal Business Name | COMMUNITY SPECIALTY HOSPITAL
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Dates
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Enumeration Date | 10/05/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1111 GALLAGHER DR
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City | SHERMAN
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State | TX
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Zip | 75090-1713
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Country | US
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Telephone | 903-870-7000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8026
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City | WICHITA FALLS
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State | TX
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Zip | 76307-8026
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Country | US
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Telephone | 940-322-3171
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Fax | 940-761-5335
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. STEWART POWERS
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Credential |
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Telephone | 903-870-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 008187
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License Number State | TX
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