Provider Demographics
NPI:1811566540
Name:SHAMROCK COMMUNITY HOSPITAL INC
Entity Type:Organization
Organization Name:SHAMROCK COMMUNITY HOSPITAL INC
Other - Org Name:HOUSTON COUNTY COMMUNITY HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RCD
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:HENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-944-6420
Mailing Address - Street 1:PO BOX 489
Mailing Address - Street 2:
Mailing Address - City:ERIN
Mailing Address - State:TN
Mailing Address - Zip Code:37061-0489
Mailing Address - Country:US
Mailing Address - Phone:336-944-6420
Mailing Address - Fax:
Practice Address - Street 1:5001 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ERIN
Practice Address - State:TN
Practice Address - Zip Code:37061-4115
Practice Address - Country:US
Practice Address - Phone:731-968-3646
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-17
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ077262Medicaid