Provider Demographics
NPI:1427048453
Name:MEDINA COUNTY HOSPITAL DISTRICT
Entity type:Organization
Organization Name:MEDINA COUNTY HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:FROSCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-426-5001
Mailing Address - Street 1:3100 AVENUE E
Mailing Address - Street 2:
Mailing Address - City:HONDO
Mailing Address - State:TX
Mailing Address - Zip Code:78861-3534
Mailing Address - Country:US
Mailing Address - Phone:830-426-7700
Mailing Address - Fax:830-426-7988
Practice Address - Street 1:3100 AVENUE E
Practice Address - Street 2:
Practice Address - City:HONDO
Practice Address - State:TX
Practice Address - Zip Code:78861-3534
Practice Address - Country:US
Practice Address - Phone:830-426-7700
Practice Address - Fax:830-426-7988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-21
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100046275N00000X
282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
No275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX212140202OtherMEDICAID ASC-HOSPITAL BASED
TXHH0562OtherBLUECROSS
TX0520593OtherAETNA
TX212140201Medicaid
TX212140202OtherMEDICAID ASC-HOSPITAL BASED
TX212140201Medicaid