Organization
SID PETERSON MEMORIAL HOSPITAL
Active
Other names
PETERSON REGIONAL MEDICAL CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
LISA MEDOVICH (CFO)
(830) 258-7632
Entity
Organization
Contact information
Practice address
551 HILL COUNTRY DR, KERRVILLE, TX 78028-6085
(830) 896-4200
(830) 258-7678
Mailing address
551 HILL COUNTRY DR, KERRVILLE, TX 78028-6085
(830) 896-4200
(830) 258-7678
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
282NR1301X
Rural Acute Care Hospital
Primary
000406
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
127294003
—
TX
01
—
HH0439
BLUE CROSS BLUE SHIELD
TX
Enumeration date
07/05/2005
Last updated
07/27/2022
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