Provider Demographics
NPI:1912153719
Name:GOOD SHEPHERD MEDICAL CENTER - MARSHALL
Entity Type:Organization
Organization Name:GOOD SHEPHERD MEDICAL CENTER - MARSHALL
Other - Org Name:HARRISON COUNTY ASSOCIATION
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR PATIENT FINANCIAL SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-927-6009
Mailing Address - Street 1:811 S WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:TX
Mailing Address - Zip Code:75670-5336
Mailing Address - Country:US
Mailing Address - Phone:903-924-6000
Mailing Address - Fax:903-934-5172
Practice Address - Street 1:811 S WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:TX
Practice Address - Zip Code:75670-5336
Practice Address - Country:US
Practice Address - Phone:903-927-6000
Practice Address - Fax:903-934-5172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-12
Last Update Date:2009-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX45T032Medicare Oscar/Certification