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Organization
METROPLEX ADVENTIST HOSPITAL, INC
Active
Organization
METROPLEX ADVENTIST HOSPITAL, INC
Active
Other names
Home Care of Metroplex Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MAMIE L LISTER RN (ADMINISTRATOR/DIRECTOR)
(254) 519-8930
Entity
Organization
Contact information
Practice address
2115 S CLEAR CREEK RD, KILLEEN, TX 76549-4110
(254) 519-8930
(254) 526-0075
Mailing address
2115 S CLEAR CREEK RD, KILLEEN, TX 76549-4110
(254) 519-8930
(254) 526-0075
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005074210
AETNA
—
01
—
015
TRICARE
—
05
—
095172501
—
TX
01
—
1316970569
NPI
—
01
—
132428100
FIRST CARE
—
01
—
236103100
US DOL/BLACK LUNG PROVIDER
—
01
—
677733
HUMANA INSURANCE GOLD CHOICE MEDICARE
—
01
—
N7148
HOMELINK
—
Enumeration date
04/27/2015
Last updated
04/27/2015
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