Provider Demographics
NPI:1235318338
Name:SMITHVILLE HOSPITAL AUTHORITY
Entity Type:Organization
Organization Name:SMITHVILLE HOSPITAL AUTHORITY
Other - Org Name:ELGIN NURSING AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BOARD PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:O
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-652-3331
Mailing Address - Street 1:1373 N AVENUE C
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:TX
Mailing Address - Zip Code:78621-1528
Mailing Address - Country:US
Mailing Address - Phone:512-285-2457
Mailing Address - Fax:512-285-2459
Practice Address - Street 1:1373 N AVENUE C
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:TX
Practice Address - Zip Code:78621-1528
Practice Address - Country:US
Practice Address - Phone:512-285-2457
Practice Address - Fax:512-285-2459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001026611Medicaid
TX360972901Medicaid
TX5517Medicaid
TX197558301Medicaid
TX001015416Medicaid
TX5517Medicaid
676180Medicare Oscar/Certification