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Organization

ATLANTA HOSPITAL AUTHORITY

Active
Other names
Atlanta Memorial Hospital
Organization subpart
No

Provider details

NPI number
Authorized official
MR. TOM CROW (ADMINISTRATOR/CEO)
(903) 799-3000
Entity
Organization

Contact information

Practice address
1007 S WILLIAM ST, ATLANTA, TX 75551-3245
(903) 799-3000
(903) 799-3005
Mailing address
PO BOX 1049, ATLANTA, TX 75551-1049
(903) 799-3000
(903) 799-3005

Taxonomy

Speciality
Code
Description
License number
State
282NR1301X
Rural Acute Care Hospital
Primary
000131
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
107585105
AR
01
122058
SUPERIOR HEALTH PLAN
TX
05
133255305
TX
05
1736589
LA
01
80274
BLUE CROSS BLUE SHIELD
AR
01
HH0664
BLUE CROSS BLUE SHIELD
TX
Enumeration date
10/09/2006
Last updated
06/15/2010
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