Healthcare Provider Details

I. General information

NPI: 1467477000
Provider Name (Legal Business Name): CHILDRESS COUNTY HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 05/24/2021
Certification Date: 05/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HWY 83 NORTH
CHILDRESS TX
79201
US

IV. Provider business mailing address

PO BOX 1030
CHILDRESS TX
79201-1030
US

V. Phone/Fax

Practice location:
  • Phone: 940-937-6371
  • Fax: 940-937-9626
Mailing address:
  • Phone: 940-937-6371
  • Fax: 940-937-9626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number004642
License Number StateTX

VIII. Authorized Official

Name: MRS. HOLLY HOLCOMB
Title or Position: CEO
Credential:
Phone: 940-937-9178