Provider Demographics
NPI:1275586620
Name:HAMILTON COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:HAMILTON COUNTY HOSPITAL DISTRICT
Other - Org Name:COLEMAN HEALTHCARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GRADY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-386-1950
Mailing Address - Street 1:2713 S COMMERCIAL AVE
Mailing Address - Street 2:
Mailing Address - City:COLEMAN
Mailing Address - State:TX
Mailing Address - Zip Code:76834-7503
Mailing Address - Country:US
Mailing Address - Phone:325-625-4105
Mailing Address - Fax:325-625-3114
Practice Address - Street 1:2713 S COMMERCIAL AVE
Practice Address - Street 2:
Practice Address - City:COLEMAN
Practice Address - State:TX
Practice Address - Zip Code:76834
Practice Address - Country:US
Practice Address - Phone:325-625-4105
Practice Address - Fax:325-625-3114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2023-05-02
Deactivation Date:2006-05-25
Deactivation Code:
Reactivation Date:2006-12-11
Provider Licenses
StateLicense IDTaxonomies
TX314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX004564OtherFACILITY ID NO
TX004564OtherFACILITY ID NO
TX1248470008Medicare NSC
TX004564OtherFACILITY ID NO