Healthcare Provider Details

I. General information

NPI: 1275947178
Provider Name (Legal Business Name): CHILDRESS COUNTY HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2014
Last Update Date: 06/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

TEN MEDICAL CENTER DRIVE
CLARENDON TX
79226
US

IV. Provider business mailing address

TEN MEDICAL CENTER DRIVE
CLARENDON TX
79226
US

V. Phone/Fax

Practice location:
  • Phone: 806-874-5221
  • Fax: 806-874-5619
Mailing address:
  • Phone: 806-874-5221
  • Fax: 806-874-5619

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN M HENDERSON
Title or Position: CEO
Credential:
Phone: 940-937-6371