Basic Information
| Provider Information | |||||||||
| NPI: | 1427171115 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ROLLING PLAINS MEMORIAL HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 E ARIZONA AVE | ||||||||
| Address2: | PO BOX 690 | ||||||||
| City: | SWEETWATER | ||||||||
| State: | TX | ||||||||
| PostalCode: | 795567120 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3252351701 | ||||||||
| FaxNumber: | 3252358705 | ||||||||
| Practice Location | |||||||||
| Address1: | 200 E ARIZONA AVE | ||||||||
| Address2: | |||||||||
| City: | SWEETWATER | ||||||||
| State: | TX | ||||||||
| PostalCode: | 795567120 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3252351701 | ||||||||
| FaxNumber: | 3252358705 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/09/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | HALL | ||||||||
| AuthorizedOfficialFirstName: | JULIE | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | SENIOR DIRECTOR, BUSINESS SERVICES | ||||||||
| AuthorizedOfficialTelephone: | 3252351701 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | 000471 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.