MEDICARE: HAMILTON COUNTY HOSPITAL DISTRICT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	273Y00000X	Rehabilitation Hospital Unit

General Provider Information

NPI Number	:	1720626609
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAMILTON COUNTY HOSPITAL DISTRICT

Provider Business Mailing Address
First Line	:	400 N BROWN ST BLDG 1
Second Line	:
City	:	HAMILTON
State	:	TX
Zip	:	76531-1518
Country	:	US
Telephone Number	:	254-386-1600
Fax Number	:

Provider Business Practice Location Address
First Line	:	1503 1/2 W FRONT ST
Second Line	:
City	:	GOLDTHWAITE
State	:	TX
Zip	:	76844-2056
Country	:	US
Telephone Number	:	325-648-3464
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	GRADY HOOPER
Credential	:
Telephone Number	:	254-386-1950

Provider Enumeration Date	:	12/11/2019
Last Update Date	:	12/11/2019

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