MEDICARE: CORE HEALTH OF DALHART, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR1300X	Rural Health Clinic/Center
2	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1275345514
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORE HEALTH OF DALHART, LLC

Provider Business Mailing Address
First Line	:	1021 E 10TH ST
Second Line	:
City	:	DALHART
State	:	TX
Zip	:	79022-4005
Country	:	US
Telephone Number	:	806-244-0003
Fax Number	:

Provider Business Practice Location Address
First Line	:	1021 E 10TH ST
Second Line	:
City	:	DALHART
State	:	TX
Zip	:	79022-4005
Country	:	US
Telephone Number	:	806-244-0003
Fax Number	:	806-288-6041

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. KRISTEN RICHARDSON
Credential	:	LVN
Telephone Number	:	806-244-0003

Provider Enumeration Date	:	01/23/2025
Last Update Date	:	01/23/2025

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