Basic Information
| Provider Information | |||||||||
| NPI: | 1770236762 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SOUTH LIMESTONE HOSPITAL DISTRICT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 169 S OAK ST | ||||||||
| Address2: | |||||||||
| City: | VAN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 757903516 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9039638641 | ||||||||
| FaxNumber: | 9039635413 | ||||||||
| Practice Location | |||||||||
| Address1: | 169 S OAK ST | ||||||||
| Address2: | |||||||||
| City: | VAN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 757903516 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9039638641 | ||||||||
| FaxNumber: | 9039635413 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/31/2022 | ||||||||
| LastUpdateDate: | 01/31/2022 | ||||||||
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| AuthorizedOfficialLastName: | PRICE | ||||||||
| AuthorizedOfficialFirstName: | LARRY | ||||||||
| AuthorizedOfficialMiddleName: | N. | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 2547293281 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 01/31/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.