1457374688 NPI number — LOCKNEY GENERAL HOSPITAL DISTRICT

Table of content: (NPI 1457374688)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457374688 NPI number — LOCKNEY GENERAL HOSPITAL DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LOCKNEY GENERAL 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:
W.J. MANGOLD 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:
1457374688
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 37
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOCKNEY
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79241-0037
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
806-652-3373
Provider Business Mailing Address Fax Number:
806-652-2417

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
320 N MAIN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOCKNEY
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79241
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-652-3373
Provider Business Practice Location Address Fax Number:
806-652-2417
Provider Enumeration Date:
07/26/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HUNT
Authorized Official First Name:
SHARON
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
806-652-3373

Provider Taxonomy Codes

  • Taxonomy code: 275N00000X , with the licence number:  000010 , 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)