Healthcare Provider Details

I. General information

NPI: 1518943216
Provider Name (Legal Business Name): FARWELL HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2005
Last Update Date: 03/26/2024
Certification Date: 03/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 5TH STREET
FARWELL TX
79325
US

IV. Provider business mailing address

305 5TH ST
FARWELL TX
79325-5615
US

V. Phone/Fax

Practice location:
  • Phone: 806-481-9027
  • Fax: 806-481-9503
Mailing address:
  • Phone: 806-481-9027
  • Fax: 806-481-9503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number111189
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: CASSIE MISTRETTA
Title or Position: MANAGER
Credential:
Phone: 205-292-4859