Healthcare Provider Details

I. General information

NPI: 1841272366
Provider Name (Legal Business Name): SHACKELFORD COUNTY HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

432 KENSHALO ST
ALBANY TX
76430-1507
US

IV. Provider business mailing address

PO BOX 1507 432 KENSHALO ST
ALBANY TX
76430-1507
US

V. Phone/Fax

Practice location:
  • Phone: 325-762-3313
  • Fax: 325-762-2342
Mailing address:
  • Phone: 325-762-3313
  • Fax: 325-762-2342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number209004
License Number StateTX

VIII. Authorized Official

Name: JOANN SHERMAN
Title or Position: BUSINESS MANAGER
Credential:
Phone: 325-762-2892