Organization
SID PETERSON MEMORIAL HOSPITAL
Active
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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