MEDICARE: WEST WHARTON 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	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1902679020
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST WHARTON COUNTY HOSPITAL DISTRICT

Provider Business Mailing Address
First Line	:	11490 GATEWAY BLVD N
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79934-3456
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11490 GATEWAY BLVD N
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79934-3456
Country	:	US
Telephone Number	:	318-812-2140
Fax Number	:

Authorized Official
Title or Position	:	DISTRICT ADMINISTRATOR
Name	:	JOHNNY THOMPSON
Credential	:
Telephone Number	:	361-771-6391

Provider Enumeration Date	:	10/31/2023
Last Update Date	:	03/07/2025

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