Organization
GLEN ROSE MEDICAL FOUNDATION
Active
Other names
GLEN ROSE MEDICAL CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
HAL MAYO (CFO)
(254) 897-2215
Entity
Organization
Contact information
Practice address
1021 HOLDEN ST, GLEN ROSE, TX 76043-4937
(254) 897-2215
(254) 897-1446
Mailing address
PO BOX 299, GLEN ROSE, TX 76043-0299
(254) 897-2215
(254) 897-1446
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
000059
TX
261QC0050X
Critical Access Hospital Clinic/Center
000059
TX
281P00000X
Chronic Disease Hospital
Primary
000059
TX
332B00000X
Durable Medical Equipment & Medical Supplies
000059
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10010265
AMERIGROUP
TX
01
—
3367917
AETNA INS
TX
01
—
HH0458
BLUE CROSS BLUE SHEILD
TX
Enumeration date
06/15/2006
Last updated
09/11/2025
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