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
1007 S WILLIAM ST, ATLANTA, TX 75551-3245
(903) 799-3000
(903) 799-3005
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00BW85
BLUE CROSS BLUE SHIELD
TX
01
—
122058
SUPERIOR HEALTH PLAN
TX
05
—
133255302
—
TX
01
—
9R041
BLUE CROSS BLUE SHIELD
AR
Enumeration date
10/26/2006
Last updated
02/03/2011
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