Provider Demographics
NPI:1649697749
Name:SEMINOLE HOSPITAL DISTRICT
Entity type:Organization
Organization Name:SEMINOLE HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:432-758-4814
Mailing Address - Street 1:1004 HOBBS HWY
Mailing Address - Street 2:SUITE 4
Mailing Address - City:SEMINOLE
Mailing Address - State:TX
Mailing Address - Zip Code:79360-3300
Mailing Address - Country:US
Mailing Address - Phone:432-758-4960
Mailing Address - Fax:432-758-4979
Practice Address - Street 1:1004 HOBBS HWY
Practice Address - Street 2:SUITE 4
Practice Address - City:SEMINOLE
Practice Address - State:TX
Practice Address - Zip Code:79360-3300
Practice Address - Country:US
Practice Address - Phone:432-758-4960
Practice Address - Fax:432-758-4979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-26
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health