1831140979 NPI number — SUTTON COUNTY HOSPITAL DISTRICT

Table of content: (NPI 1831140979)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831140979 NPI number — SUTTON COUNTY HOSPITAL DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SUTTON COUNTY HOSPITAL DISTRICT
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
LILLIAN M HUDSPETH MEMORIAL HOSPITAL
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1831140979
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/13/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 455
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SONORA
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76950-0455
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
325-387-2521
Provider Business Mailing Address Fax Number:
325-387-2396

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
308 HUDSPETH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SONORA
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76950-8003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
325-387-2521
Provider Business Practice Location Address Fax Number:
325-387-2396
Provider Enumeration Date:
05/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BADGETT
Authorized Official First Name:
CHRIS
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
325-387-1210

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 282NC0060X , with the licence number: 147000 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 121781205 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: HH0145 . This is a "BCBS PROVIDER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com