Organization
SOMERVELL COUNTY HOSPITAL DISTRICT
Active
Other names
GLEN ROSE MEDICAL CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
EARL R REYNOLDS (C.E.O.)
(254) 897-1425
Entity
Organization
Contact information
Practice address
1021 HOLDEN ST, GLEN ROSE, TX 76043-4937
(254) 897-2215
(254) 897-1446
Mailing address
1021 HOLDEN ST, GLEN ROSE, TX 76043-4937
(254) 897-2215
(254) 897-1446
Taxonomy
Speciality
Code
Description
License number
State
282NR1301X
Rural Acute Care Hospital
Primary
000059
TX
332B00000X
Durable Medical Equipment & Medical Supplies
000059
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121800003
—
TX
05
—
121800004
—
TX
01
—
200134272
ALL MANAGED CARE INS
TX
01
—
HH0458
BLUE CROSS BLUE SHIELD
TX
Enumeration date
06/08/2006
Last updated
12/22/2014
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