Provider Demographics
NPI:1548269111
Name:HUNT MEMORIAL HOSPITAL DISTRICT
Entity type:Organization
Organization Name:HUNT MEMORIAL HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:HOSPITAL CONTRACT AND CREDENTIALING
Authorized Official - Prefix:MS
Authorized Official - First Name:CECELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:VALENTINE
Authorized Official - Suffix:
Authorized Official - Credentials:CRCS-I
Authorized Official - Phone:903-408-1142
Mailing Address - Street 1:4001 RIDGECREST RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75402-6143
Mailing Address - Country:US
Mailing Address - Phone:903-408-1950
Mailing Address - Fax:903-408-1969
Practice Address - Street 1:3900 JOE RAMSEY BLVD E BLDG 1
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75401-7727
Practice Address - Country:US
Practice Address - Phone:903-408-1950
Practice Address - Fax:903-408-1969
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HUNT MEMORIAL HOSPITAL DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-07-18
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX002557251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX024783501Medicaid
TX677657Medicare Oscar/Certification