Provider Demographics
NPI:1477551125
Name:GAINESVILLE HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:GAINESVILLE HOSPITAL DISTRICT
Other - Org Name:NTMC HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELENE
Authorized Official - Middle Name:M
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:940-612-8602
Mailing Address - Street 1:1615 HOSPITAL BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:GAINESVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76240-2020
Mailing Address - Country:US
Mailing Address - Phone:940-668-2094
Mailing Address - Fax:940-612-8601
Practice Address - Street 1:1615 HOSPITAL BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:GAINESVILLE
Practice Address - State:TX
Practice Address - Zip Code:76240-2020
Practice Address - Country:US
Practice Address - Phone:940-668-2094
Practice Address - Fax:940-612-8601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00380251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXHH9053OtherBCBS
TX02-360408-02Medicaid
TX02-360408-02Medicaid