Organization
SHANNON MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS PATRICIA KIRKHAM (BILLING SUPERVISOR)
(325) 657-5031
Entity
Organization
Contact information
Practice address
120 E HARRIS AVE, SAN ANGELO, TX 76903-5904
(325) 657-5031
Mailing address
PO BOX 1879, SAN ANGELO, TX 76902-1879
(325) 657-5031
Taxonomy
Speciality
Code
Description
License number
State
281PC2000X
Children's Chronic Disease Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
094720202
—
TX
05
—
137226011
—
TX
Enumeration date
03/25/2006
Last updated
08/26/2011
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