Healthcare Provider Details

I. General information

NPI: 1245396258
Provider Name (Legal Business Name): PYRAMID HEALTHCARE CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 W. ROOSEVELT
GORMAN TX
76454
US

IV. Provider business mailing address

PO BOX 2105
WHITNEY TX
76692-5105
US

V. Phone/Fax

Practice location:
  • Phone: 254-734-2202
  • Fax: 254-734-2220
Mailing address:
  • Phone: 254-580-9424
  • Fax: 254-580-9892

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number119012
License Number StateTX

VIII. Authorized Official

Name: MRS. PATRICIA DIANE WARD
Title or Position: CEO PRESIDENT
Credential: RN
Phone: 254-580-9424