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Organization

BSA HOSPITAL, LLC

Active
Other names
BSA Health System EMS
Organization subpart
No

Provider details

NPI number
Authorized official
STEPHEN C. PETROVICH (VICE PRESIDENT)
(615) 296-3000
Entity
Organization

Contact information

Practice address
615 W HIGHWAY 60, CANYON, TX 79015-7302
(806) 336-8042
Mailing address
615 W HIGHWAY 60, CANYON, TX 79015-7302
(806) 655-7726
(806) 655-5529

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
1000883
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1000883
TEXAS DEPARTMENT OF STATE HEALTH SERVICES
TX
Enumeration date
02/05/2018
Last updated
07/16/2025
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