Organization
LAIRD MEMORIAL HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BOB ELLZEY (CEO/PRESIDENT)
(903) 983-4352
Entity
Organization
Contact information
Practice address
1612 S HENDERSON BLVD, KILGORE, TX 75662-3518
(903) 983-4308
(903) 983-4306
Mailing address
1612 S HENDERSON BLVD, KILGORE, TX 75662-3518
(903) 983-4308
(903) 983-4306
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
31
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5290733
UNITED HEALTHCARE
TX
01
—
85352
AMERICAID
TX
01
—
HH0109
BLUECROSS BLUE SHIELD
TX
Enumeration date
08/22/2005
Last updated
08/22/2020
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