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General NPI Number Information
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NPI Number | 1275242489
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Entity Type | Organization
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Legal Business Name | SOUTH LIMESTONE HOSPITAL DISTRICT
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Dates
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Enumeration Date | 11/16/2022
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Last Update Date | 10/30/2024
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Provider Practice Location Address
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Address Line | 200 N PEARL ST
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City | MART
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State | TX
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Zip | 76664-1142
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Country | US
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Telephone | 254-729-3281
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Fax | 254-729-3080
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Provider Business Mailing Address
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Address Line | 701 MCCLINTIC DR
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City | GROESBECK
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State | TX
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Zip | 76642-2128
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Country | US
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Telephone | 254-729-3281
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Fax |
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Authorized Official
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Title or Position | CHIEF COMPLIANCE OFFICER
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Name | JULIE ANN WILSON
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Credential |
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Telephone | 254-729-3281
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QC0050X
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Taxonomy Name | Critical Access Hospital Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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