Healthcare Provider Details

I. General information

NPI: 1194324079
Provider Name (Legal Business Name): WEST WHARTON COUNTY HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2020
Last Update Date: 04/05/2022
Certification Date: 04/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 FM 3220
CLIFTON TX
76634-1034
US

IV. Provider business mailing address

6937 WARFIELD AVE
SYKESVILLE MD
21784-7454
US

V. Phone/Fax

Practice location:
  • Phone: 254-675-2828
  • Fax:
Mailing address:
  • Phone: 410-552-4800
  • Fax: 410-552-4837

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: DAVID H MAK
Title or Position: CFO
Credential:
Phone: 713-569-7370