Provider Demographics
NPI:1902808355
Name:HOPKINS COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:HOPKINS COUNTY HOSPITAL DISTRICT
Other - Org Name:HOPKINS COUNTY HOSPICE
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF OPERATING / FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:GEIKEN
Authorized Official - Last Name:WALLACE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-439-4052
Mailing Address - Street 1:PO BOX 275
Mailing Address - Street 2:
Mailing Address - City:SULPHUR SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:75483-0275
Mailing Address - Country:US
Mailing Address - Phone:903-885-7671
Mailing Address - Fax:
Practice Address - Street 1:1228 CHURCH ST
Practice Address - Street 2:
Practice Address - City:SULPHUR SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:75482-2195
Practice Address - Country:US
Practice Address - Phone:903-885-7671
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-15
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000219100Medicaid
HH6853OtherBLUE CROSS BLUE SHIELD
HH6853OtherBLUE CROSS BLUE SHIELD