MEDICARE: WILBARGER COUNTY HOSPITAL DISTRICT

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	261QE0700X	End-Stage Renal Disease (ESRD) Treatment Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	HH0641	OTHER	TX	BLUE CROSS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	015021	OTHER	TX	KHC PROVIDER NUMBER

General Provider Information

NPI Number	:	1578688834
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILBARGER COUNTY HOSPITAL DISTRICT

Provider Business Mailing Address
First Line	:	1000 GARLAND JOHNSTON DR
Second Line	:
City	:	VERNON
State	:	TX
Zip	:	76384-4097
Country	:	US
Telephone Number	:	940-552-9351
Fax Number	:	940-553-2981

Provider Business Practice Location Address
First Line	:	1000 GARLAND JOHNSTON DR
Second Line	:
City	:	VERNON
State	:	TX
Zip	:	76384-4097
Country	:	US
Telephone Number	:	940-553-2960
Fax Number	:	940-553-2955

Authorized Official
Title or Position	:	COO/CNO
Name	:	MS. TONYA PRICE
Credential	:	RN
Telephone Number	:	940-553-2813

Provider Enumeration Date	:	03/19/2007
Last Update Date	:	12/30/2025

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Directions to “WILBARGER COUNTY HOSPITAL DISTRICT ” Practice Location

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