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General NPI Number Information
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NPI Number | 1295719227
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Entity Type | Organization
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Legal Business Name | EAST TEXAS MEDICAL CENTER-GILMER
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Dates
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Enumeration Date | 12/02/2005
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Last Update Date | 03/11/2014
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Provider Practice Location Address
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Address Line | 712 N WOOD ST
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City | GILMER
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State | TX
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Zip | 75644-1751
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Country | US
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Telephone | 903-841-7100
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Fax | 903-946-5531
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Provider Business Mailing Address
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Address Line | P.O. BOX 1304
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City | PITTSBURG
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State | TX
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Zip | 75686-2203
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Country | US
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Telephone | 903-946-5519
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Fax | 903-946-5531
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Authorized Official
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Title or Position | REGIONAL DIRECTOR OF BUSINESS SER
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Name | MR. TAMBRI L ROLSTON
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Credential |
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Telephone | 903-946-5500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 008068
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License Number State | TX
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