Provider Demographics
NPI:1881691061
Name:GRAHAM HOSPITAL DISTRICT
Entity type:Organization
Organization Name:GRAHAM HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:LANDRUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-521-5302
Mailing Address - Street 1:1301 MONTGOMERY ROAD
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:TX
Mailing Address - Zip Code:76450
Mailing Address - Country:US
Mailing Address - Phone:940-549-3400
Mailing Address - Fax:940-549-5156
Practice Address - Street 1:1301 MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:TX
Practice Address - Zip Code:76450-4240
Practice Address - Country:US
Practice Address - Phone:940-549-3400
Practice Address - Fax:940-549-5156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-05
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000094282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX130613601Medicaid
TX24478201Medicaid
TX63522901Medicaid
TX1001013Medicaid
TX94053801Medicaid
TX130613604Medicaid
TX167174501Medicaid
TX458585Medicare Oscar/Certification
TX00HE20Medicare Oscar/Certification
TX24478201Medicaid
TX1001013Medicaid
TX94053801Medicaid
TX63522901Medicaid
TX450085Medicare Oscar/Certification
TX458851Medicare Oscar/Certification