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General NPI Number Information
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NPI Number | 1407089386
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Entity Type | Organization
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Legal Business Name | ALLEGIANCE SPECIALTY HOSPITAL OF KILGORE
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Dates
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Enumeration Date | 08/26/2009
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Last Update Date | 08/26/2009
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Provider Practice Location Address
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Address Line | 1612 S HENDERSON BLVD
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City | KILGORE
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State | TX
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Zip | 75662-3518
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Country | US
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Telephone | 903-984-3505
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Fax |
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Provider Business Mailing Address
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Address Line | 1612 S HENDERSON BLVD
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City | KILGORE
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State | TX
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Zip | 75662-3518
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Country | US
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Telephone | 903-984-3505
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF PHARMACY
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Name | DR. HAMEED A AKILO
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Credential | PHARMD
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Telephone | 903-983-4309
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | 26142
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License Number State | TX
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