Provider Demographics
NPI:1285617597
Name:MENARD COUNTY HOSPITAL DISTRICT
Entity type:Organization
Organization Name:MENARD COUNTY HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MENARD MANOR ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BOBBI
Authorized Official - Middle Name:
Authorized Official - Last Name:HEYMAN COMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:RN, LNFA
Authorized Official - Phone:325-396-4515
Mailing Address - Street 1:PO BOX 608
Mailing Address - Street 2:
Mailing Address - City:MENARD
Mailing Address - State:TX
Mailing Address - Zip Code:76859-0608
Mailing Address - Country:US
Mailing Address - Phone:325-396-4515
Mailing Address - Fax:325-396-2731
Practice Address - Street 1:100 GAY STREET
Practice Address - Street 2:
Practice Address - City:MENARD
Practice Address - State:TX
Practice Address - Zip Code:76859-0608
Practice Address - Country:US
Practice Address - Phone:325-396-4515
Practice Address - Fax:325-396-2731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-22
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110786314000000X
314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000407502Medicaid
TX000407502Medicaid
5625790001Medicare NSC