Provider Demographics
NPI:1104870435
Name:EASTLAND MEMORIAL HOSPITAL DISTRICT
Entity type:Organization
Organization Name:EASTLAND MEMORIAL HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LABAN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-754-1317
Mailing Address - Street 1:125 INSPIRATION BLVD
Mailing Address - Street 2:
Mailing Address - City:EASTLAND
Mailing Address - State:TX
Mailing Address - Zip Code:76448-5512
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:125 INSPIRATION BLVD
Practice Address - Street 2:
Practice Address - City:EASTLAND
Practice Address - State:TX
Practice Address - Zip Code:76448-5512
Practice Address - Country:US
Practice Address - Phone:254-629-1779
Practice Address - Fax:254-629-0943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2025-03-07
Deactivation Date:2006-05-25
Deactivation Code:
Reactivation Date:2006-11-21
Provider Licenses
StateLicense IDTaxonomies
TX314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX004933OtherFACILITY ID NO.
TX675001Medicare Oscar/Certification
TX675001Medicare Oscar/Certification