Provider Demographics
NPI:1427171115
Name:ROLLING PLAINS MEMORIAL HOSPITAL
Entity type:Organization
Organization Name:ROLLING PLAINS MEMORIAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP BUSINESS SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-235-1701
Mailing Address - Street 1:200 E ARIZONA AVE
Mailing Address - Street 2:PO BOX 690
Mailing Address - City:SWEETWATER
Mailing Address - State:TX
Mailing Address - Zip Code:79556-7120
Mailing Address - Country:US
Mailing Address - Phone:325-235-1701
Mailing Address - Fax:325-235-8705
Practice Address - Street 1:200 E ARIZONA AVE
Practice Address - Street 2:
Practice Address - City:SWEETWATER
Practice Address - State:TX
Practice Address - Zip Code:79556-7120
Practice Address - Country:US
Practice Address - Phone:325-235-1701
Practice Address - Fax:325-235-8705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000471367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX133244702Medicaid