Organization
SHANNON MEDICAL CENTER
Active
Parent organization
SHANNON MEDICAL CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
SHANNON MEDICAL CENTER
Authorized official
MISS PATRICIA KIRKHAM (BILLING SUPERVISOR)
(325) 657-5031
Entity
Organization
Contact information
Practice address
2018 PULLIAM ST, SAN ANGELO, TX 76905-5148
(325) 657-5031
Mailing address
PO BOX 1879, SAN ANGELO, TX 76902-1879
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000916102
—
TX
01
—
HH2625
BLUE CROSS SNF
TX
Enumeration date
03/24/2006
Last updated
08/26/2011
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