Healthcare Provider Details

I. General information

NPI: 1043094394
Provider Name (Legal Business Name): PECOS COUNTY MEMORIAL HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2023
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

387 W IH 10
FORT STOCKTON TX
79735
US

IV. Provider business mailing address

387 W IH 10
FORT STOCKTON TX
79735
US

V. Phone/Fax

Practice location:
  • Phone: 432-336-7044
  • Fax:
Mailing address:
  • Phone: 432-336-7044
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QC0050X
TaxonomyCritical Access Hospital Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: BETSY L BRISCOE
Title or Position: CEO
Credential:
Phone: 432-336-4201