Provider Demographics
NPI:1851606040
Name:BAYLOR COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:BAYLOR COUNTY HOSPITAL DISTRICT
Other - Org Name:SEYMOUR PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:HARDIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-889-5572
Mailing Address - Street 1:201 STADIUM DR STE 1
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:TX
Mailing Address - Zip Code:76380-2343
Mailing Address - Country:US
Mailing Address - Phone:940-888-2222
Mailing Address - Fax:940-888-5574
Practice Address - Street 1:201 STADIUM DR STE 1
Practice Address - Street 2:
Practice Address - City:SEYMOUR
Practice Address - State:TX
Practice Address - Zip Code:76380-2343
Practice Address - Country:US
Practice Address - Phone:940-888-2222
Practice Address - Fax:940-888-5574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-11
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TX269583336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX146332Medicaid
2126648OtherPK