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Organization
SID PETERSON MEMORIAL HOSPITAL
Active
Organization
SID PETERSON MEMORIAL HOSPITAL
Active
Other names
PETERSON REGIONAL MEDICAL CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
LISA MEDOVICH (CFO)
(830) 258-7632
Entity
Organization
Contact information
Practice address
551 HILL COUNTRY DR, KERRVILLE, TX 78028-6085
(830) 896-4200
(830) 258-7678
Mailing address
551 HILL COUNTRY DR, KERRVILLE, TX 78028-6085
(830) 896-4200
(830) 258-7678
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
NULL
282NR1301X
Rural Acute Care Hospital
Primary
000406
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
127294003
—
TX
01
—
HH0439
BLUE CROSS BLUE SHIELD
TX
Enumeration date
07/05/2005
Last updated
07/27/2022
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