Organization
SID PETERSON MEMORIAL HOSPITAL
Active
Other names
Peterson Hospice
Organization subpart
No
Provider details
NPI number
Authorized official
LISA MEDOVICH (CHIEF FINANCIAL OFFICER)
(830) 258-7632
Entity
Organization
Contact information
Practice address
250 CULLY DRIVE, KERRVILLE, TX 78028
(830) 258-7799
(830) 258-7009
Mailing address
250 CULLY DRIVE, KERRVILLE, TX 78028-5950
(830) 258-7799
(830) 258-7009
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1016019
—
TX
Enumeration date
11/15/2006
Last updated
07/27/2022
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