Organization
SHERMAN GRAYSON HOSPITAL LLC
Active
Other names
D/B/A Healthcenter on 1417
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VANCE VERNON REYNOLDS (PRESIDENT & CHIEF EXECUTIVE OFFICER)
(903) 870-4591
Entity
Organization
Contact information
Practice address
1000 S FM 1417, SHERMAN, TX 75092-4865
(903) 870-4611
(903) 891-2030
Mailing address
119 W HOUSTON ST, SHERMAN, TX 75090-5909
(903) 891-7000
(903) 813-1479
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
282N00000X
General Acute Care Hospital
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00U24J
BLUE CROSS BLUE SHIELD
TX
01
—
018042401
TX MEDICAID T-STEPS
TX
05
—
063537701
—
TX
Enumeration date
06/15/2006
Last updated
06/21/2011
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