Provider Demographics
NPI:1376646653
Name:HOSPICE OF BALLINGER
Entity Type:Organization
Organization Name:HOSPICE OF BALLINGER
Other - Org Name:HOSPICE OF BALLINGER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:LEON
Authorized Official - Last Name:COWART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-365-3889
Mailing Address - Street 1:PO BOX 350
Mailing Address - Street 2:
Mailing Address - City:BALLINGER
Mailing Address - State:TX
Mailing Address - Zip Code:76821-0350
Mailing Address - Country:US
Mailing Address - Phone:325-365-2375
Mailing Address - Fax:325-365-5484
Practice Address - Street 1:818 HUTCHINS AVE
Practice Address - Street 2:
Practice Address - City:BALLINGER
Practice Address - State:TX
Practice Address - Zip Code:76821-5611
Practice Address - Country:US
Practice Address - Phone:325-365-2375
Practice Address - Fax:325-365-5484
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BALLINGER HOME HEALTH INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-05
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX671570251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX015166OtherDADS
TX015166OtherDADS