Provider Demographics
NPI:1104025618
Name:BALLINGER MEMORIAL HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:BALLINGER MEMORIAL HOSPITAL DISTRICT
Other - Org Name:BALLINGER HEALTHCARE AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR, CORPORATE AFFAIRS
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:WIMSATT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-550-9400
Mailing Address - Street 1:2001 N 6TH ST
Mailing Address - Street 2:
Mailing Address - City:BALLINGER
Mailing Address - State:TX
Mailing Address - Zip Code:76821-2500
Mailing Address - Country:US
Mailing Address - Phone:325-365-5766
Mailing Address - Fax:325-365-5449
Practice Address - Street 1:2001 N 6TH ST
Practice Address - Street 2:
Practice Address - City:BALLINGER
Practice Address - State:TX
Practice Address - Zip Code:76821-2500
Practice Address - Country:US
Practice Address - Phone:325-365-5766
Practice Address - Fax:325-365-5449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-13
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118303314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001015186Medicaid
TX67-5614OtherMEDICARE SNF