Provider Demographics
NPI:1922044106
Name:HOPKINS COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:HOPKINS COUNTY HOSPITAL DISTRICT
Other - Org Name:THE CLAIRMONT TYLER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/CFO
Authorized Official - Prefix:
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:RUTHERFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-438-4566
Mailing Address - Street 1:900 S BAXTER AVE
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-2209
Mailing Address - Country:US
Mailing Address - Phone:903-597-8192
Mailing Address - Fax:903-597-8213
Practice Address - Street 1:900 S BAXTER AVE
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-2209
Practice Address - Country:US
Practice Address - Phone:903-597-8192
Practice Address - Fax:903-597-8213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001025945Medicaid
TX455485Medicare Oscar/Certification
TX455485Medicare Oscar/Certification