Healthcare Provider Details

I. General information

NPI: 1669424388
Provider Name (Legal Business Name): CHILDRESS COUNTY HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 05/25/2021
Certification Date: 05/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 7TH ST NW
CHILDRESS TX
79201-2627
US

IV. Provider business mailing address

901 US HIGHWAY 83 N
CHILDRESS TX
79201-2320
US

V. Phone/Fax

Practice location:
  • Phone: 940-937-8668
  • Fax: 940-937-8772
Mailing address:
  • Phone: 940-937-6371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number140844
License Number StateTX

VIII. Authorized Official

Name: HOLLY HOLCOMB
Title or Position: CEO
Credential:
Phone: 940-937-6371