SID PETERSON MEMORIAL HOSPITAL NPI 1063584803

NPI Information

NPI: 1063584803
Provider Name: SID PETERSON MEMORIAL HOSPITAL
Classification: Hospice Care, Community Based - 251G00000X
Entity Type: Organization
Doing Business As: PETERSON HOSPICE
Address: 250 CULLY DRIVE
KERRVILLE, TX
ZIP 78028
Phone: (830) 258-7799

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NPI Details

SID PETERSON MEMORIAL HOSPITAL is a hospice care community based in Kerrville, TX. SID PETERSON MEMORIAL HOSPITAL NPI is 1063584803. The provider is registered as an organization entity type.
The provider Is Doing Business As Peterson Hospice.

The provider's business location address is:

250 CULLY DRIVE
KERRVILLE, TX
ZIP 78028
Phone: (830) 258-7799
Fax: (830) 258-7009

The provider's authorized official is Lisa Medovich .
The authorized official title is Chief Financial Officer and has the following contact phone number (830) 258-7632.

The enumeration date for this NPI number is 11/15/2006 and was last updated on 7/27/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	251G00000X	Hospice Care, Community Based			TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1016019	MEDICAID	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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